FORM 1023-EZ for PALISADES YOUTH SOCCER ASSOCIATION

Field Data
EIN 23-2771787
Case Number EO-2017069-000213
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PALISADES YOUTH SOCCER ASSOCIATION
Organization’s Mailing Address 34 THOMAS FREE DRIVE
City KINTNERSVILLE
State PA
ZIP 18930
Accounting period End 12
Primary contact name TIMOTHY HOUGHTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIMOTHY HOUGHTON
TRAVEL DIRECTOR / PRESIDENT
4 ERWINNA VALLEY WAY
ERWINNA PA 18920

Officer/Director/Trustee Two

BRUCE JOHNSON
VICE PRESIDENT
35 ALEXANDER ROAD
KINTNERSVILLE PA 18930

Officer/Director/Trustee Three

JOELENE CAMPBELL
SECRETARY
346 BEAVER RUN RD
OTTSVILLE PA 18942

Officer/Director/Trustee Four

CHRISTINA KENNEDY
REGISTRAR
1374 RIVER ROAD
UPPER BLACK EDDY PA 18973

Officer/Director/Trustee Five

NIKKI BOWEN
INTRAMURAL DIRECTOR
31 BEVERLY DRIVE
KINTNERSVILLE PA 18930

Organization’s website WWW.PYSANET.COM
Organization’s email INFO@PYSANET.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/1978
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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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