FORM 1023-EZ for BIG BLUE YOUTH SPORTS ASSOCIATION

Field Data
EIN 87-1156002
Case Number EO-2021165-000596
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BIG BLUE YOUTH SPORTS ASSOCIATION
Organization’s Mailing Address 315 39TH AVE SW STE 14
City PUYALLUP
State WA
ZIP 98373
Accounting period End 12
Primary contact name JAMES B PIZL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY DIENER
DIRECTOR
14927 87TH AVE E
PUYALLUP WA 98375

Officer/Director/Trustee Two

LINDSAY BURNWORTH
DIRECTOR
8317 228TH ST CT E
GRAHAM WA 98338

Officer/Director/Trustee Three

KRISTINA MOATS
DIRECTOR
20102 110TH AVE CT E
GRAHAM WA 98338

Officer/Director/Trustee Four

LAUREN SCOTT BARNWELL
DIRECTOR
13117 145TH ST E
PUYALLUP WA 98374

Officer/Director/Trustee Five

DUSTIN SMITH
DIRECTOR
8708 366TH ST E
EATONVILLE WA 98328

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2021
Organization Incorporation State WA
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: No
Religious: No
Educational: Yes
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 AMY DIENER
Signature Title DIRECTOR
Signature Date 6/11/2021

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