FORM 1023-EZ for LONE SAILOR DIVISION USNSCC CORPORATION

Field Data
EIN 83-1577981
Case Number EO-2018337-000263
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LONE SAILOR DIVISION USNSCC CORPORATION
Organization’s Mailing Address 12145 SAPPHIRE DRIVE
City CLERMONT
State FL
ZIP 34711
Accounting period End 12
Primary contact name BILLY G DOVER JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BILLY G DOVER JR
CEO
7640 BROKEN ARROW TRAIL
WINTER PARK FL 32792

Officer/Director/Trustee Two

RAFAEL P LOPES
COO
12145 SAPPHIRE DRIVE
CLERMONT FL 34711

Officer/Director/Trustee Three

ANDREW B RAUT
CFO
701 APRICOT DRIVE
OCOEE FL 34761

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 ANDREW B RAUT
Signature Title CFO
Signature Date 11/29/18

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