FORM 1023-EZ for BURLINGTON-EDISON LACROSSE CLUB

Field Data
EIN 84-2489234
Case Number EO-2019246-000466
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BURLINGTON-EDISON LACROSSE CLUB
Organization’s Mailing Address P O BOX 158
City BURLINGTON
State WA
ZIP 98233
Accounting period End 6
Primary contact name CHRIS RIGGS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER HILL
CO-PRESIDENT
12614 EAGLE DRIVE
BURLINGTON WA 98233-3810

Officer/Director/Trustee Two

BRIDGET FLADEBO
CO-PRESIDENT
18954 SULPHUR SPRINGS RD
MOUNT VERNON WA 98274

Officer/Director/Trustee Three

DAN GORTON
VICE PRESIDENT
5428 DUSTY LANE
BURLINGTON WA 98233-8581

Officer/Director/Trustee Four

CHRISTINE RIGGS
TREASURER
17338 WIDGEON LANE
BOW WA 98232-9700

Officer/Director/Trustee Five

ALICIA WISEMAN-SCHEMM
SECRETARY
16938 DONNELLY RD
MOUNT VERNON WA 98273-4773

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/19
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
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 CHRISTINE RIGGS
Signature Title TREASURER
Signature Date 8/31/19

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