FORM 1023-EZ for SEHOME BOYS LACROSSE

Field Data
EIN 82-2740328
Case Number EO-2017264-000087
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SEHOME BOYS LACROSSE
Organization’s Mailing Address 1050 LARRABEE AVE STE 104 423
City BELLINGHAM
State WA
ZIP 98225
Accounting period End 12
Primary contact name JOEL FUJIWARA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES HOLSTINE
PRESIDENT
881 EAST LAKE SAMISH
BELLINGHAM WA 98229

Officer/Director/Trustee Two

JEFF KRUSNIAK
VICE PRESIDENT
1826 SAMISH LANE
BELLINGHAM WA 98229

Officer/Director/Trustee Three

ANN WARK
SECRETARY
1120 37TH STREET
BELLINGHAM WA 98229

Officer/Director/Trustee Four

JOEL FUJIWARA
TREASURER
3018 ALVARADO DRIVE
BELLINGHAM WA 98229

Officer/Director/Trustee Five

STEPHEN COOK
BOARD MEMBER
703 NEWELL STREET
BELLINGHAM WA 98229

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/2017
Organization Incorporation State WA
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: 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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