FORM 1023-EZ for HEDGESVILLE YOUTH FOOTBALL ASSOCIATION

Field Data
EIN 81-5287625
Case Number EO-2017215-000006
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEDGESVILLE YOUTH FOOTBALL ASSOCIATION
Organization’s Mailing Address PO BOX 338
City HEDGESVILLE
State WV
ZIP 25427
Accounting period End 12
Primary contact name SAMANTHA YOUNG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON OVERHOLSER
SECRETARY
16 RETIREMENT LANE APT 111
MARTINSBURG WV 25404

Officer/Director/Trustee Two

SAMANTHA YOUNG
VICE PRESIDENT
65 ANAGRAM DRIVE
FALLING WATERS WV 25419

Officer/Director/Trustee Three

ANDREW BOHRER
PRESIDENT
2427 BUTLERS CHAPEL RD
MARTINSBURG WV 25403

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2017
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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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