FORM 1023-EZ for LYNCHBURG YOUTH HOCKEY ASSOCIATION

Field Data
EIN 51-0672551
Case Number EO-2014275-000441
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LYNCHBURG YOUTH HOCKEY ASSOCIATION
Organization’s Mailing Address 124 THUNDER RIDGE ROAD
City HUDDLESTON
State VA
ZIP 24104
Accounting period End 12
Primary contact name SHANE TURNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHANE TURNER
PRESIDENT
125 HIGH PEAK ROAD
MONROE VA 24574

Officer/Director/Trustee Two

CHRIS HARA
VICE PRESIDENT
287 LYNBROOK RD
RUSTBURG VA 24588-3568

Officer/Director/Trustee Three

TOM SHAHADY
SECRETARY
2005 OAK PARK PL
LYNCHBURG VA 24503-1858

Officer/Director/Trustee Four

JEFF PROWSE
DIRECTOR OF COACHING
124 THUNDER RIDGE ROAD
HUDDLESTON VA 24104

Officer/Director/Trustee Five

STEVE STADTHERR
DIRECTOR
294 STONE ROAD
RUSTBURG VA 24588

Organization’s website HTTP://LYNCHBURGYOUTHHOCKEY.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2008
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
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
Signature Title
Signature Date

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