FORM 1023-EZ for LAKE NORMAN STORM FOOTBALL TEAM INC

Field Data
EIN 47-1018950
Case Number EO-2014223-000109
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE NORMAN STORM FOOTBALL TEAM INC
Organization’s Mailing Address 6695 FOX RIDGE CIRCLE
City DAVIDSON
State NC
ZIP 28036
Accounting period End 12
Primary contact name JAMES BLAKEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES BLAKEY
DIRECTOR
6695 FOX RIDGE CIRCLE
DAVIDSON NC 28036

Officer/Director/Trustee Two

TOM CAMELI
DIRECTOR
132 PARKSIDE LN
MOORESVILLE NC 28117

Officer/Director/Trustee Three

CHUCK WHITINGTON
DIRECTOR
294 RANKIN HILL ROAD
TROUTMAN NC 28166

Organization’s website WWW.LKNSTORM.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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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