FORM 1023-EZ for THE JACKSON POLAR BEAR SOFTBALL CLUB

Field Data
EIN 36-4620875
Case Number EO-2017229-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE JACKSON POLAR BEAR SOFTBALL CLUB
Organization’s Mailing Address 7600 FULTON DR NW
City MASSILLON
State OH
ZIP 44646
Accounting period End 12
Primary contact name ANDREA FORNICOLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREA FORNICOLA
PRESIDENT, DIRECTOR
4971 MACLAREN AVE NW
MASSILLON OH 44646

Officer/Director/Trustee Two

GINA VEIGEL
SECRETARY, DIRECTOR
4926 AMESBURY CIR NW
MASSILLO OH 44646

Officer/Director/Trustee Three

JANET DARRAH
TREASURER, DIRECTOR
4751 FLEETWOOD AVE NW
CANTON OH 44718

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/26/2017
Organization Incorporation State OH
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: 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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