FORM 1023-EZ for PPB LACROSSE CLUB

Field Data
EIN 81-5210608
Case Number EO-2017067-000631
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PPB LACROSSE CLUB
Organization’s Mailing Address 535 PRINCETON AVE
City BRICK
State NJ
ZIP 08724-4827
Accounting period End 12
Primary contact name KAREN BECKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY GAVALETZ
PRESIDENT
734 SPRUCE HILL DRIVE
TOMS RIVER NJ 08735

Officer/Director/Trustee Two

PAMELA BURNS
SECRETARY
226 BAY BEACH WAY
LAVALLETTE NJ 08735

Officer/Director/Trustee Three

KAREN BECKER
VP, TREASURER
535 PRINCETON AVE
BRICK NJ 08724-4827

Officer/Director/Trustee Four

ROBERT BECKER
VP
535 PRINCETON AVE
BRICK NJ 08724

Officer/Director/Trustee Five

JOSEPH WERGZYNIAK
VP
1005 GOWDY AVENUE
POINT PLEASANT BEACH NJ 08742

Organization’s website
Organization’s email PTBEACHLAX@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2017
Organization Incorporation State NJ
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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