FORM 1023-EZ for DUBOIS REGIONAL TENNIS ASSOCIATION

Field Data
EIN 85-3637272
Case Number EO-2021127-000162
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DUBOIS REGIONAL TENNIS ASSOCIATION
Organization’s Mailing Address 4326 BUNDY SETTLEMENT ROAD
City BROCKPORT
State PA
ZIP 15823
Accounting period End 12
Primary contact name LORI SABATOSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORI SABATOSE
PRESIDENT
4326 BUNDY SETTLEMENT ROAD
BROCKPORT PA 15823

Officer/Director/Trustee Two

NOAH SERAFINI
VICE-PRESIDENT
189 CROSS CREEK VILLAGE LANE
BROCKWAY PA 15824

Officer/Director/Trustee Three

SHELLY ASKEY
TREASURER
1229 TREASURE LAKE
DUBOIS PA 15801

Officer/Director/Trustee Four

JENNIFER KEITH
SECRETARY
602 WEST WEBER AVE
DUBOIS PA 15801

Officer/Director/Trustee Five

KASSIE BREM
DIRECTOR OF COMM
1102 EAST ESCHBACH ROAD
SAINT MARYS PA 15857

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N66 - Tennis, Racquet Sports Clubs, Leagues
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LORI SABATOSE
Signature Title PRESIDENT
Signature Date 5/5/2021

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