FORM 1023-EZ for SOUTH LANE BUZZARDS FOOTBALL INC

Field Data
EIN 47-3005005
Case Number EO-2015037-000084
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH LANE BUZZARDS FOOTBALL INC
Organization’s Mailing Address 585 HAMILTON STREET
City SPRINGFIELD
State OR
ZIP 97477
Accounting period End 12
Primary contact name SAMUEL STAPP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIC RICH
PRESIDENT
226 SOUTH 35TH STREET
SPRINGFIELD OR 97478

Officer/Director/Trustee Two

JOSHUA KENNEDY
TREASURER
791 THRONE DRIVE APT 104
EUGENE OR 97402

Officer/Director/Trustee Three

JOHN KIEWERT
VICE PRESIDENT
585 HAMILTON STREET
SPRINGFIELD OR 97477

Officer/Director/Trustee Four

SAMUEL STAPP
SECRETARY
585 HAMILTON STREET
SPRINGFIELD OR 97477

Officer/Director/Trustee Five

DENNIS CAPEL
REPRESENTATIVE
104 S 63RD
SPRINGFIELD OR 97478

Organization’s website WWW.SPRINGFIELDBUZZARDS.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2015
Organization Incorporation State OR
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: 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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