FORM 1023-EZ for FRASER VALLEY LACROSSE CLUB

Field Data
EIN 81-1097024
Case Number EO-2016223-000086
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRASER VALLEY LACROSSE CLUB
Organization’s Mailing Address PO BOX 1782
City FRASER
State CO
ZIP 80442
Accounting period End 12
Primary contact name JOHN NIEDZWIECKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN NIEDZWIECKI
PRESIDENT/BOARD CHAIR
39 COUNTY ROAD 8303
TABERNASH CO 80478

Officer/Director/Trustee Two

JOHN VELLA
DIRECTOR OF OPERATIONS
516 FOX LANE UNIT A
FRASER CO 80442

Officer/Director/Trustee Three

JOHN MONKOUSKI
DIRECTOR OF ADMINISTRATION
322 CORONA TRAIL
TABERNASH CO 80478

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/14/2016
Organization Incorporation State CO
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 Yes
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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