FORM 1023-EZ for BURNING RIVER SOCCER CLUB

Field Data
EIN 81-1767160
Case Number EO-2016210-000079
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BURNING RIVER SOCCER CLUB
Organization’s Mailing Address 4287 RIDGELAND CIRCLE
City CLEVELAND
State OH
ZIP 44135-1000
Accounting period End 6
Primary contact name KESTUTIS PETRAITIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KESTUTIS PETRAITIS
PRESIDENT
4287 RIDGELAND CIRCLE
CLEVELAND OH 44135-1000

Officer/Director/Trustee Two

KATIE VEASEY
VICE PRESIDENT
425 W LAKESIDE AVE APT 604
CLEVELAND OH 44113-1029

Officer/Director/Trustee Three

DALE MILLISON
SECRETARY
19466 HENRY ROAD
FAIRVIEW PARK OH 44126-1638

Officer/Director/Trustee Four

ANTHONY VRATARIC
TREASURER
865 AUDREY DRIVE
EASTLAKE OH 44095-2242

Officer/Director/Trustee Five

KRISTINA PETRAITIS
DIRECTOR
3659 W 128TH
CLEVELAND OH 44111-4524

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/2016
Organization Incorporation State OH
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: 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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