FORM 1023-EZ for LOCO DISC GOLF CLUB

Field Data
EIN 30-0932179
Case Number EO-2016111-000202
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOCO DISC GOLF CLUB
Organization’s Mailing Address 1604 SPRING HILL ROAD STE 300
City VIENNA
State VA
ZIP 22182
Accounting period End 12
Primary contact name MICHAEL S SULLIVAN ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRIAN JUNKINS
CHAIRMAN
34243 LEXINGTON FARM LANE
BLUEMONT VA 20135

Officer/Director/Trustee Two

JOHN ILIFF
VICE-CHAIRMAN
38283 COLES COURT
HAMILTON VA 20158

Officer/Director/Trustee Three

CHRIS MATTHIESEN
TREASURER
42520 MAYFLOWER TERRACE
ASHBURN VA 20148

Officer/Director/Trustee Four

STEVE GANZ
SECRETARY
1066 MENLOW DRIVE NE
LEESBURG VA 20176

Officer/Director/Trustee Five

STEPHAN EVERS
DIRECTOR AT-LARGE
35803 HAYMAN LANE
ROUND HILL VA 20141

Organization’s website HTTP://WWW.LOCODISCGOLF.COM
Organization’s email INFO@LOCODISCGOLF.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/10/2016
Organization Incorporation State VA
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: 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
Signature Title
Signature Date

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