FORM 1023-EZ for PARKSIDE BASKETBALL ACADEMY INC

Field Data
EIN 81-5153786
Case Number EO-2017044-000431
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PARKSIDE BASKETBALL ACADEMY INC
Organization’s Mailing Address 4642 LESLIE ANN LN
City MOUNT PLEASANT
State WI
ZIP 53043
Accounting period End 12
Primary contact name JACOB YORG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACOB YORG
PRESIDENT, DIRECTOR
4642 LESLIE ANN LN
MOUNT PLEASANT WI 53043

Officer/Director/Trustee Two

COURTNEY BOYD
SECRETARY, DIRECTOR
4642 LESLIE ANN LN
MOUNT PLEASANT WI 53043

Officer/Director/Trustee Three

DEAN MLACHNIK
TREASURER, DIRECTOR
4642 LESLIE ANN LN
MOUNT PLEASANT WI 53043

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/9/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
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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