FORM 1023-EZ for CAMERON COUNTY STORM FOOTBALL INC

Field Data
EIN 47-5102086
Case Number EO-2015295-000339
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMERON COUNTY STORM FOOTBALL INC
Organization’s Mailing Address 601 WOODLAND AVE PO BOX 346
City EMPORIUM
State PA
ZIP 15834
Accounting period End 12
Primary contact name JEANNE MIGLICIO ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEITH BAUGHMAN
PRESIDENT/DIRECTOR
290 OLD PORTAGE ROAD
EMPORIUM PA 15834

Officer/Director/Trustee Two

CHRISTINE FOWLER
TREASURER
99 W 7TH STREET
EMPORIUM PA 15834

Officer/Director/Trustee Three

JOSHUA SMITH
VICE PRES/DIRECTOR
190 LAURELWOOD CT
EMPORIUM PA 15834

Officer/Director/Trustee Four

CARL BROWN
GEN MGR/DIRECTOR
3201 RICH VALLEY
EMPORIUM PA 15834

Officer/Director/Trustee Five

TARA NEWTON
SEC/DIRECTOR
115 E 6TH STREET
EMPORIUM PA 15834

Organization’s website NA
Organization’s email CCSTORMBOARD@ZITOMEDIA.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/20/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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
Signature Title
Signature Date

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