FORM 1023-EZ for MCCALLUM LACROSSE CLUB BOOSTER ORGANIZATION

Field Data
EIN 81-5222758
Case Number EO-2017212-000359
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MCCALLUM LACROSSE CLUB BOOSTER ORGANIZATION
Organization’s Mailing Address 4933 STRASS DRIVE
City AUSTIN
State TX
ZIP 78731
Accounting period End 7
Primary contact name BLAIR DANCY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BLAIR DANCY
PRESIDENT
4933 STRASS DRIVE
AUSTIN TX 78731

Officer/Director/Trustee Two

LEE NUDELMAN
VICE PRESIDENT
7206 BREEZY PASS COVE
AUSTIN TX 78749

Officer/Director/Trustee Three

DREW MILLER
TREASURER
1402 ARCADIA AVENUE
AUSTIN TX 78757

Officer/Director/Trustee Four

AMY KULIK
SECRETARY
8304 JANCY DRIVE
AUSTIN TX 78750

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/27/2017
Organization Incorporation State TX
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: Yes
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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