FORM 1023-EZ for PENINSULA SPORTS FUNDRAISING

Field Data
EIN 81-1567816
Case Number EO-2016113-000167
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PENINSULA SPORTS FUNDRAISING
Organization’s Mailing Address 28 REGAL WAY
City HAMPTON
State VA
ZIP 23669
Accounting period End 7
Primary contact name CLARENCE LEATHERBURY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TINA LEATHERBURY
PRESIDENT
28 REGAL WAY
HAMPTON VA 23669

Officer/Director/Trustee Two

CLARENCE LEATHERBURY
VICE PRESIDENT
28 REGAL WAY
HAMPTON VA 23669

Officer/Director/Trustee Three

STACY TALAYUMPTEWA
TREASURER
316 RIVERSIDE DR
YORKTOWN VA 23692

Officer/Director/Trustee Four

MINDY HICKMAN
SECRETARY
42 DEEP CREEK RD
NEWPORT NEWS VA 23606

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 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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