FORM 1023-EZ for CATEGORY 5 LACROSSE INC

Field Data
EIN 47-1175369
Case Number EO-2014356-000447
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CATEGORY 5 LACROSSE INC
Organization’s Mailing Address 1020 DONNA LANE
City HUNTINGTOWN
State MD
ZIP 20639
Accounting period End 12
Primary contact name CHARLES W BROWN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLES W BROWN JR
PRESIDENT
1020 DONNA LANE
HUNTINGTOWN MD 20639

Officer/Director/Trustee Two

ALISA BROWN
TREASURER
1020 DONNA LANE
HUNTINGTOWN MD 20639

Officer/Director/Trustee Three

ERIK ALLEN
VICE PRESIDENT
3900 PARK PLACE
HUNTINGTOWN MD 20639

Officer/Director/Trustee Four

SYLVIA LUCKETT
SECRETARY
4431 ESTATE DRIVE
HUNTINGTOWN MD 20639

Officer/Director/Trustee Five

MIKE HYLAND
BOARD MEMBER AT LARGE
3125 HOLLAND CLIFF ROAD
HUNTINGTOWN MD 20639

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/18/2014
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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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