FORM 1023-EZ for CIVITAN CLUB OF TYSONS

Field Data
EIN 58-1582906
Case Number EO-2015035-000342
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CIVITAN CLUB OF TYSONS
Organization’s Mailing Address 1051 NORTH GEORGE MASON DRIVE
City ARLINGTON
State VA
ZIP 22205
Accounting period End 9
Primary contact name JACQUELINE M ABRAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT LIVINGSTONE
PRESIDENT
6501 MILLER DRIVE
ALEXANDRIA VA 22315-3515

Officer/Director/Trustee Two

DON GLASCO
PRESIDENT ELECT
14203 FRANKLIN STREET
WOODBRIDGE VA 22191-2524

Officer/Director/Trustee Three

LINDA POWELL
SECRETARY
1623 WOODMOOR LANE
MCLEAN VA 22101-5160

Officer/Director/Trustee Four

JACQUELINE ABRAMS
TREASURER
1051 NORTH GEORGE MASON DRIVE
ARLINGTON VA 22205-2564

Officer/Director/Trustee Five

LINDA HADLEY
IMMEDIATE PAST PRESIDENT
263 GUNDRY DRIVE
FALS CHURCH VA 22046-4117

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/2006
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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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