FORM 1023-EZ for JEFFERSON SOCCER CLUB

Field Data
EIN 82-2925480
Case Number EO-2017275-000432
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JEFFERSON SOCCER CLUB
Organization’s Mailing Address 73 E SATIN ST
City JEFFERSON
State OH
ZIP 44047
Accounting period End 12
Primary contact name EVAN HOWE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN KERECKY
VICE PRESIDENT
309 WESTVIEW DR
JEFFERSON OH 44047

Officer/Director/Trustee Two

ERROL TALCOTT
TREASURER
163 W JEFFERSON ST
JEFFERSON OH 44047

Officer/Director/Trustee Three

SETH GILMAN
SECRETARY
1455 CLAY ST
JEFFERSON OH 44047

Officer/Director/Trustee Four

EVAN HOWE
PRESIDENT
73 E SATIN ST
JEFFERSON OH 44047

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/28/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: No
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 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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