FORM 1023-EZ for POTOMAC HIGHLANDS SOCCER LEAGUE INC

Field Data
EIN 83-1646183
Case Number EO-2018235-000409
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POTOMAC HIGHLANDS SOCCER LEAGUE INC
Organization’s Mailing Address 420 HIGH LANE
City MATHIAS
State WV
ZIP 26812
Accounting period End 12
Primary contact name DONNA ALEXANDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRIS ALTOBELLO
PRESIDENT
757 PINEPOINTE DRIVE
KEYSER WV 26726

Officer/Director/Trustee Two

CARLA KAPOSY
VICE PRESIDENT
202 HOUSTON DRIVE
PETERSBURG WV 26847

Officer/Director/Trustee Three

TONYA PERSINGER
SECRETARY
PO BOX 473
MATHIAS WV 26812

Officer/Director/Trustee Four

STACEY HUFFMAN
TREASURER
68 EILEEN DRIVE
KEYSER WV 26726

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/18
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CARLA KAPOSY
Signature Title VICE PRESIDENT
Signature Date 8/21/18

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