FORM 1023-EZ for FC PHOENIX SOCCER CLUB DBA SOUTHERNOREGON SOCCER ACADEMY

Field Data
EIN 93-1295189
Case Number EO-2019353-000209
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FC PHOENIX SOCCER CLUB DBA SOUTHERNOREGON SOCCER ACADEMY
Organization’s Mailing Address PO BOX 219
City PHOENIX
State OR
ZIP 97535
Accounting period End 12
Primary contact name CHRISTOPHER VAN NESS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER VAN NESS
PRESIDENT
PO BOX 1563
PHOENIX OR 97535

Officer/Director/Trustee Two

PATTI KING
SECRETARY
315 N PINE ST
PHOENIX OR 97535

Officer/Director/Trustee Three

WILLIAM KING
MEMBER AT LARGE
315 N PINE ST
PHOENIX OR 97535

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/2001
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O23 - Boys and Girls Clubs (Combined)
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 Yes
Correctness Declaration Yes
Signature Name CHRISTOPHER VAN NESS
Signature Title PRESIDENT
Signature Date 12/17/2019

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