FORM 1023-EZ for LANCASTER COUNTY DISC GOLF CLUB

Field Data
EIN 84-4506454
Case Number EO-2021082-000787
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LANCASTER COUNTY DISC GOLF CLUB
Organization’s Mailing Address 163 HOSTETTER LN
City LANCASTER
State PA
ZIP 17602
Accounting period End 12
Primary contact name TRAVIS DOMBACH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRAVIS DOMBACH
PRESIDENT
24 BIRCH DR
WILLOW STREET PA 17584

Officer/Director/Trustee Two

SCOTT MOYER
TREASURER
463 MEMORIAL HWY
FLEETWOOD PA 19522

Officer/Director/Trustee Three

SHAWN CONROY
VICE PRESIDENT
163 HOSTETTER LN
LANCASTER PA 17602

Officer/Director/Trustee Four

WESLEY MOYER
SECRETARY
924 CHESTNUT STREET
AKRON PA 17501

Officer/Director/Trustee Five

AARON HOWARD
COMMUNICATIONS DIRECTOR
323 COLLEGE AVE
LANCASTER PA 17603

Organization’s website LCDGC.COM
Organization’s email LANCASTERDISCGOLF@OUTLOOK.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 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 TRAVIS DOMBACH
Signature Title PRESIDENT
Signature Date 1/31/2021

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