FORM 1023-EZ for EASTERN PIKE YOUTH SOCCER CLUB

Field Data
EIN 82-1339782
Case Number EO-2017191-000358
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EASTERN PIKE YOUTH SOCCER CLUB
Organization’s Mailing Address PO BOX 1572
City MILFORD
State PA
ZIP 18337
Accounting period End 12
Primary contact name JOHN J MCGOVERN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWN BOLLES
PRESIDENT/DIRECTOR
101 PARKSIDE LANE
DINGMANS FERRY PA 18328

Officer/Director/Trustee Two

MAURICE MATTESON
VICE-PRESIDENT/DIRECTOR
903 AVENUE I
MATAMORAS PA 18336

Officer/Director/Trustee Three

REBECCA WALLS
SECRETARY/DIRECTOR
109 SUNNYLANDS ROAD
MILFORD PA 18337

Officer/Director/Trustee Four

DEREK EVERSDYKE
TREASURER/DIRECTOR
124 SQUIRREL ROAD
DINGMANS FERRY PA 18328

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/27/2017
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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