FORM 1023-EZ for KEYSTONE YOUTH BASKETBALL ASSOCIATION

Field Data
EIN 84-4713537
Case Number EO-2020064-000189
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KEYSTONE YOUTH BASKETBALL ASSOCIATION
Organization’s Mailing Address 497 OLD PARK ROAD
City LEWISTOWN
State PA
ZIP 17044-7618
Accounting period End 7
Primary contact name ERIC DILLMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW LITZINGER
PRESIDENT
497 OLD PARK RD
LEWISTOWN PA 17044

Officer/Director/Trustee Two

RYAN PHEASANT
VICE-PPRESIDENT
3895 STULL ROAD
MCCLURE PA 17841

Officer/Director/Trustee Three

ERIC DILLMAN
TREASURER
706 SOUTH GRAND STREET
LEWISTOWN PA 17044

Officer/Director/Trustee Four

JESS NAIL
SECRETARY
103 BETTY CIRCLE
REEDSVILLE PA 17084

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/14/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 No
Correctness Declaration Yes
Signature Name MATTHEW LITZINGER
Signature Title PRESIDENT
Signature Date 2/29/2020

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