FORM 1023-EZ for THE LACROSSE ACADEMY

Field Data
EIN 87-1141836
Case Number EO-2021172-000104
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE LACROSSE ACADEMY
Organization’s Mailing Address 140 MONTECITO AVE APT 203
City OAKLAND
State CA
ZIP 94610
Accounting period End 12
Primary contact name PAUL JEPSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL JEPSEN
CO FOUNDER
140 MONTECITO AVE APT 203
OAKLAND CA 94610

Officer/Director/Trustee Two

NED WEBSTER
CO FOUNDER
84 THE ALAMEDA
SAN ANSELMO CA 94960

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PAUL JEPSEN
Signature Title CO FOUNDER
Signature Date 6/16/2021

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