FORM 1023-EZ for GROTON-MYSTIC BASKETBALL

Field Data
EIN 83-4235259
Case Number EO-2019143-000176
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GROTON-MYSTIC BASKETBALL
Organization’s Mailing Address 20 GARDEN CT
City MYSTIC
State CT
ZIP 6355
Accounting period End 9
Primary contact name ERIK GEMALY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIK GEMALY
PRESIDENT
20 GARDEN CT
MYSTIC CT 6355

Officer/Director/Trustee Two

BONNIE TOMPKINS
VICE PRESIDENT
100 WESTWOOD DR
GROTON CT 6340

Officer/Director/Trustee Three

MATTHEW LONGINO
TREASURER
350 GALES FERRY ROAD
GROTON CT 6340

Officer/Director/Trustee Four

KRISTIN GEMALY
SECRETARY
20 GARDEN CT
MYSTIC CT 6355

Officer/Director/Trustee Five

BRUCE WAGNER
PARENT REP
92 IVY CT
GROTON CT 6340

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/24/19
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ERIK GEMALY
Signature Title PRESIDENT
Signature Date 5/21/19

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