FORM 1023-EZ for TETON VALLEY YOUTH LACROSSE ASSOCIATION INC

Field Data
EIN 81-2826228
Case Number EO-2016288-000192
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TETON VALLEY YOUTH LACROSSE ASSOCIATION INC
Organization’s Mailing Address 1394 FRONTIER TRL
City VICTOR
State ID
ZIP 83455
Accounting period End 12
Primary contact name BRENDON MCHARGUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRENDON MCHARGUE
TREASURER
1394 FRONTIER TRL
VICTOR ID 83455

Officer/Director/Trustee Two

MIKE DAWES
MEMBER AT LARGE
9215 MEGAN ST
VICTOR ID 83455

Officer/Director/Trustee Three

DEREK DIVENERE
VICE PRESIDENT
4010 WEST9500 SOUTH
VICTOR ID 83455

Officer/Director/Trustee Four

NATE FIENBERG
PRESIDENT
145 ELM ST
VICTOR ID 83455

Officer/Director/Trustee Five

DAVE HUDASKO
SECRETARY
1165 BROOK TROUT
VICTOR ID 83455

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/2016
Organization Incorporation State ID
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
Signature Title
Signature Date

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