FORM 1023-EZ for MERCER MENS LACROSSE BOOSTER CLUB CARE OF BORMEL GRICE HUYETT PA

Field Data
EIN 81-3582943
Case Number EO-2017125-000183
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MERCER MENS LACROSSE BOOSTER CLUB CARE OF BORMEL GRICE HUYETT PA
Organization’s Mailing Address 14409 GREENVIEW DRIVE SUITE 201
City LAUREL
State MD
ZIP 20708
Accounting period End 12
Primary contact name MARK CARTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK CARTER
PRESIDENT
3228 ROSCOMMON DRIVE
GLENELG MD 21737

Officer/Director/Trustee Two

JOHN GIBSON
TREASURER
4378 SAINT ANDREWS STREET
HOWELL MI 48843

Officer/Director/Trustee Three

MARK FROMERT
VP, FUNDRAISING EVENTS
411 ANNETTE AVENUE
STEVENSVILLE MD 21666

Officer/Director/Trustee Four

MIKE EWING
SECRETARY/COMMUNICATIONS
20331 AYOUB LANE
HAGERSTOWN MD 21742

Officer/Director/Trustee Five

TODD ENSOR
PAST PRESIDENT
15006 B PRICEVILLE ROAD
SPARKS MD 21152

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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
Signature Title
Signature Date

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