FORM 1023-EZ for BARR-WATKINS SOCCER ASSOCIATION

Field Data
EIN 84-2086201
Case Number EO-2021103-000008
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BARR-WATKINS SOCCER ASSOCIATION
Organization’s Mailing Address PO BOX 401
City NORTHERN CAMBRIA
State PA
ZIP 15714
Accounting period End 12
Primary contact name KELLY MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY MILLER
BOARD PRESIDENT
221 APPLE STREET
NORTHERN CAMBRIA PA 15714

Officer/Director/Trustee Two

BRUCE MORICONI
VICE PRESIDENT
407 MOSS CREEK RD
NORTHERN CAMBRIA PA 15714

Officer/Director/Trustee Three

SANDRA BOLVIN
TREASUER
1200 ELDER AVENUE
NORTHERN CAMBRIA PA 15714

Officer/Director/Trustee Four

JASON SHERRY
OUTREACH
PO BOX 46
EMEIGH PA 15738

Officer/Director/Trustee Five

MICHAEL HANEY
COACH ADMINISTRATOR
135 CLARKE STREET
NORTHERN CAMBRIA PA 15714

Organization’s website
Organization’s email BARRWATKINGSOCCER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/2019
Organization Incorporation State PA
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: 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 KELLY MILLER
Signature Title BOARD PRESIDENT
Signature Date 4/5/2021

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