FORM 1023-EZ for QC ELITE SOCCER CLUB

Field Data
EIN 81-3091850
Case Number EO-2016187-000164
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QC ELITE SOCCER CLUB
Organization’s Mailing Address 14328 104TH STREET
City COAL VALLEY
State IL
ZIP 61240
Accounting period End 6
Primary contact name ALICIA SYSLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALICIA SYSLO
PRESIDENT SECRETARY
PO BOX 1491
MILAN IL 61264

Officer/Director/Trustee Two

TODD BRANDT
VICE PRESIDENT
PO BOX 1491
MILAN IL 61264

Officer/Director/Trustee Three

MEGAN MAYNARD
TREASURER
PO BOX 1491
MILAN IL 61264

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2016
Organization Incorporation State IL
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: 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 Yes
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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