FORM 1023-EZ for LIGHTS OUT TRACK AND FIELD CLUB

Field Data
EIN 38-3886009
Case Number EO-2016161-000318
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHTS OUT TRACK AND FIELD CLUB
Organization’s Mailing Address PO BOX 1123
City LEWISVILLE
State NC
ZIP 27023
Accounting period End 8
Primary contact name CHRIS JOINES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRIS JOINES
ATHLETIC DIRECTOR
6410 WEEPING WILLOW COURT
BELEWS CREEK NC 27009

Officer/Director/Trustee Two

ANTWAN HUGHES
PRESIDENT
200 W 25TH STREET
WINSTON SALEM NC 27105

Officer/Director/Trustee Three

DECARLOS WEST
HEAD COACH
3527 GLEN LYON DRIVE
WINSTON SALEM NC 27127

Officer/Director/Trustee Four

ROBERT DOWD
TREASURER
908 RIDGE GATE DRIVE
LEWISVILLE NC 27023

Organization’s website WWW.LIGHTSOUTTRACKANDFIELD.COM
Organization’s email LIGHTSOUTTRACK@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2012
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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