FORM 1023-EZ for BROWNSTOWN YOUTH SOCCER

Field Data
EIN 81-3519492
Case Number EO-2018197-000230
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BROWNSTOWN YOUTH SOCCER
Organization’s Mailing Address 72
City BROWNSTOWN
State IN
ZIP 47220
Accounting period End 12
Primary contact name ADAM DISQUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AYLSSA VIECK
PRESIDENT
4700 S CO RD 500 W
VALLONIA IN 47281

Officer/Director/Trustee Two

LEVI NEHRT
VICE PRESIDENT
809 W SPRING ST
BROWNSTOWN IN 47220

Officer/Director/Trustee Three

ADAM DISQUE
TREASURER
535 N COUNTY RD 1050 W
NORMAN IN 47260

Officer/Director/Trustee Four

AMY UNDERWOOD
BOARD MEMBER
135 E STEINKAMP RD
BROWNSTOWN IN 47220

Officer/Director/Trustee Five

DAVE FISHER
BOARD MEMBER
1392 S CO RD 150 W
BROWNSTOWN IN 47220

Organization’s website
Organization’s email BROWNSTOWNYOUTHSOCCER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/15
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 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 AYLSSA VIECK
Signature Title PRESIDENT
Signature Date 7/12/18

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