FORM 1023-EZ for BLACK BEAR YOUTH LACROSSE ASSOCIATION

Field Data
EIN 81-1976090
Case Number EO-2018008-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK BEAR YOUTH LACROSSE ASSOCIATION
Organization’s Mailing Address PO BOX 312
City STRAFFORD
State NH
ZIP 3851
Accounting period End 8
Primary contact name BRIAN GODWIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE OKEEFE
PRESIDENT
62 PROVINCE ROAD
STRAFFORD NH 3884

Officer/Director/Trustee Two

RYAN HANAVAN
BOYS PROGRAM DIRECTOR
31 KNOWLES WAY
NORTHWOOD NH 3261

Officer/Director/Trustee Three

TOM JOHNSON
GIRLS PROGAM DIRECTOR
23 SMOKE STREET
NOTTINGHAM NH 3290

Officer/Director/Trustee Four

BRIAN GODWIN
TREASURER
17 FRANCESCA WAY
NOTTINGHAM NH 3290

Officer/Director/Trustee Five

JENN READEL
SECRETARY
400 2ND CROWN POINT ROAD
STRAFFORD NH 3884

Organization’s website BLACKBEARLACROSSE.ORG
Organization’s email BLACKBEARLACROSSEINFO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/28/16
Organization Incorporation State NH
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 BRIAN GODWIN
Signature Title TREASURER
Signature Date 1/5/18

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