FORM 1023-EZ for WEST PERRY MAT CLUB

Field Data
EIN 84-2319850
Case Number EO-2021271-000057
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WEST PERRY MAT CLUB
Organization’s Mailing Address 6 W MAIN STREET
City NEW BLOOMFIELD
State PA
ZIP 17068
Accounting period End 12
Primary contact name MELISSA LOWE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD RUSH
PRESIDENT
265 BURN HILL ROAD
SHERMANS DALE PA 17090

Officer/Director/Trustee Two

SCOTT MORRISON
VICE PRESIDENT
6 W MAIN ST
NEW BLOOMFIELD PA 17068

Officer/Director/Trustee Three

MELISSA LOWE
TREASURER
2090 JERICHO RD
NEW BLOOMFIELD PA 17068

Officer/Director/Trustee Four

MICHELLE JACKSON
SECRETARY
16 MILL RD
SHERMANS DALE PA 17090

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/2019
Organization Incorporation State PA
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: Yes
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 MELISSA LOWE
Signature Title TREASURER
Signature Date 9/24/2021

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