FORM 1023-EZ for PENINSULA LACROSSE ASSOCIATION

Field Data
EIN 47-1741356
Case Number EO-2014295-000435
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PENINSULA LACROSSE ASSOCIATION
Organization’s Mailing Address PO BOX 2584
City GIG HARBOR
State WA
ZIP 98335
Accounting period End 8
Primary contact name MICHELLE MEERDINK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHELLE MEERDINK
PRESIDENT
14509 57TH AVE NW
GIG HARBOR WA 98332

Officer/Director/Trustee Two

HAYLEY NICHOLS
VICE PRESIDENT
15822 PEACOCK HILL AVE NW
GIG HARBOR WA 98332

Officer/Director/Trustee Three

GRETCHEN COSTANZI
TREASURER
PO BOX 1196
PORT ORCHARD WA 98366

Officer/Director/Trustee Four

JOHANNA OLIVE
SECRETARY
12211 49TH AVE CT NW
GIG HARBOR WA 98332

Officer/Director/Trustee Five

PAUL AKULSCHIN
ATHLETIC DIRECTOR
14508 48TH AVENUE CT NW
GIG HARBOR WA 98332

Organization’s website WWW.PENINSULALACROSSE.COM
Organization’s email PENINSULALAX@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics 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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