FORM 1023-EZ for PIRATE GIRLS HOCKEY

Field Data
EIN 84-2676933
Case Number EO-2019234-000399
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PIRATE GIRLS HOCKEY
Organization’s Mailing Address 332 CRESCENT AVENUE
City CROOKSTON
State MN
ZIP 56716
Accounting period End 6
Primary contact name BRENT EPEMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRENT EPEMA
PRESIDENT
332 Crescent Ave
CROOKSTON MN 56716-1364

Officer/Director/Trustee Two

HEATH HANSON
VICE PRESIDENT
907 SOUTH WASHINGTON
CROOKSTON MN 56716-1364

Officer/Director/Trustee Three

DERICK SEAVER
SECRETARY
27882 305TH ST SW
CROOKSTON MN 56716-1364

Officer/Director/Trustee Four

TREVOR BREKKEN
TREASURER
109 GOLF TERRACE
CROOKSTON MN 56716-1364

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRENT EPEMA
Signature Title PRESIDENT
Signature Date 8/20/19

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