FORM 1023-EZ for MADISON LACROSSE CLUB

Field Data
EIN 85-4225303
Case Number EO-2021084-001273
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MADISON LACROSSE CLUB
Organization’s Mailing Address 24844 MAKANI LN
City MADISON
State AL
ZIP 35756
Accounting period End 12
Primary contact name MATTHEW OSBORNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW OSBORNE
PRESIDENT
24844 MAKANI LN
MADISON AL 35756

Officer/Director/Trustee Two

NAVARRO MICHAEL
VICE PRESIDENT
128 WELLINGTON DRIVE
MADISON AL 35758

Officer/Director/Trustee Three

NICOLE WALTERS
TREASURER
112 INDIAN CREST DR
MADISON AL 35758

Officer/Director/Trustee Four

JEFFREY HAVERTY
SECRETARY
113 IDARED LANE
MADISON AL 35758

Organization’s website MADISONLAX.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2020
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: Yes
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 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 OSBORNE
Signature Title PRESIDENT
Signature Date 2/6/2021

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