FORM 1023-EZ for MEDICAL LAKE DIRT DAWGS BASEBALL CLUB

Field Data
EIN 84-4922491
Case Number EO-2020076-000154
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEDICAL LAKE DIRT DAWGS BASEBALL CLUB
Organization’s Mailing Address 714 S BROOKS RD
City MEDICAL LAKE
State WA
ZIP 99022
Accounting period End 12
Primary contact name LANCE A MICHAUD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LANCE MICHAUD
PRESIDENT
714 S BROOKS RD
MEDICAL LAKE WA 99022

Officer/Director/Trustee Two

MELISSA MICHAUD
TRUSTEE
714 S BROOKS RD
MEDICAL LAKE WA 99022

Organization’s website
Organization’s email MLDIRTDAWGS@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/2020
Organization Incorporation State WA
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: 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 LANCE MICHAUD
Signature Title PRESIDENT
Signature Date 3/12/2020

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