FORM 1023-EZ for NORTHERN VIRGINIA ATHLETIC CLUB

Field Data
EIN 87-0797038
Case Number EO-2016032-000268
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHERN VIRGINIA ATHLETIC CLUB
Organization’s Mailing Address 18264 OAKRIDGE HAMLET PLACE
City PURCELLVILLE
State VA
ZIP 20132
Accounting period End 12
Primary contact name MICHAEL STANSBURY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL STANSBURY
PRESIDENT
119 BALCH SPRINGS CIR SE
LEESBURG VA 20175

Officer/Director/Trustee Two

MARC HUNTER
DIRECTOR OF OPERATIONS
18264 OAKRIDGE HAMLET PLACE
PURCELLVILLE VA 20132

Officer/Director/Trustee Three

PAUL SMAGH
VICE PRESIDENT
21312 MARSH CREEK DRIVE
BROADLANDS VA 20148

Officer/Director/Trustee Four

ANDREA SMAGH
SECRETARY
21312 MARSH CREEK DRIVE
BROADLANDS VA 20148

Officer/Director/Trustee Five

RICHARD HAYDEN
TREASURER
20388 ALTAVISTA WAY
ASHBURN VA 20147

Organization’s website WWW.LEAGUELINEUP.COM/NOVAAC
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/2007
Organization Incorporation State VA
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 Yes
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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