FORM 1023-EZ for TIDEWATER LACROSSE

Field Data
EIN 36-4968020
Case Number EO-2020252-000777
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TIDEWATER LACROSSE
Organization’s Mailing Address 2465 PITCHFORK WAY
City VIRGINIA BEACH
State VA
ZIP 23456
Accounting period End 6
Primary contact name STACI WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STACI WILLIAMS
DIRECTOR/PRESIDENT
2465 PITCHFORK WAY
VIRGINIA BEACH VA 23456

Officer/Director/Trustee Two

JODI BURVIDE
DIRECTOR/SECRETARY
4560 MORNINGSIDE DRIVE
EDEN NY 14057

Organization’s website WWW.TIDEWATERLACROSSE.COM
Organization’s email TIDEWATERLACROSSE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2020
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 STACI WILLIAMS
Signature Title DIRECTOR/PRESIDENT
Signature Date 9/6/2020

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