FORM 1023-EZ for MOSES LAKE ATHLETIC TRAINING CENTER

Field Data
EIN 82-4807666
Case Number EO-2018106-001073
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOSES LAKE ATHLETIC TRAINING CENTER
Organization’s Mailing Address 1122 S JEFFERSON AVENUE
City MOSES LAKE
State WA
ZIP 98837
Accounting period End 12
Primary contact name MIKE SHEA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL SHEA
DIRECTOR
1122 S JEFFERSON AVE
MOSES LAKE WA 98837

Officer/Director/Trustee Two

TODD HOFFER
DIRECTOR
4843 BLUFF DRIVE NE
MOSES LAKE WA 98837

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/14/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
Organization’s purpose Charitable: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHAEL SHEA
Signature Title DIRECTOR
Signature Date 4/12/18

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