FORM 1023-EZ for DELAVAN SOCCER CLUB INC

Field Data
EIN 39-2038800
Case Number EO-2018080-000020
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DELAVAN SOCCER CLUB INC
Organization’s Mailing Address PO BOX 864
City DELAVAN
State WI
ZIP 53115
Accounting period End 12
Primary contact name LAURA F PATTERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD MAASS
PRESIDENT
859 COMUS DR
DELAVAN WI 53115

Officer/Director/Trustee Two

KASSANDRA HUERTA
VICE PRESIDENT
104 N 5TH STREET
DELAVAN WI 53115

Officer/Director/Trustee Three

JOSH DUESTERBECK
SECRETARY
209 AUTUMN DR
DELAVAN WI 53115

Officer/Director/Trustee Four

LAURA PATTERSON
TREASURER
7966 WINDMILL WAY
DELAVAN WI 53115

Officer/Director/Trustee Five

JODY ZIPP
REGISTRAR
134 MARINO AVE
DELAVAN WI 53115

Organization’s website DELAVANSOCCERCLUB.COM
Organization’s email LAURA.PATTERSON@BMO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/29/01
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Correctness Declaration Yes
Signature Name LAURA PATTERSON
Signature Title TREASURER
Signature Date 3/18/18

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