FORM 1023-EZ for TIPP CITY LACROSSE CLUB

Field Data
EIN 82-3102642
Case Number EO-2018009-000019
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TIPP CITY LACROSSE CLUB
Organization’s Mailing Address 7742 WINDING WAY N
City TIPP
State OH
ZIP 45371
Accounting period End 12
Primary contact name JARED TRUMAN PITTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORI PAULET
PRESIDENT
8110 DOG LEG RD
DAYTON OH 45414

Officer/Director/Trustee Two

JARED PITTS
VICE PRESIDENT
7742 WINDING WAY N
TIPP CITY OH 45371

Officer/Director/Trustee Three

MICHELLE RHODES
SECRETARY
2605 SENECA DR
TROY OH 45373

Officer/Director/Trustee Four

DAVID COBB
TREASURER
6655 KESSLER FREDRICK RD
TIPP CITY OH 45371

Organization’s website WWW.TIPPCITYLACROSSE.COM
Organization’s email TIPPLACROSSE@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/17
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: 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JARED PITTS
Signature Title VICE PRESIDENT
Signature Date 1/5/18

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