FORM 1023-EZ for EMBREY MILL SWIM TEAM

Field Data
EIN 84-3320663
Case Number EO-2019309-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMBREY MILL SWIM TEAM
Organization’s Mailing Address 25 APRICOT STREET
City STAFFORD
State VA
ZIP 22554
Accounting period End 12
Primary contact name STEPHANIE SHOOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE SHOOK
PRESIDENT, BOARD OF DIRECTORS
25 APRICOT STREET
STAFFORD VA 22554

Officer/Director/Trustee Two

NITU NEPAL
TREASURER, BOARD OF DIRECTORS
25 APRICOT STREET
STAFFORD VA 22554

Officer/Director/Trustee Three

JEANNE DURHAM
VICE PRESIDENT, BOARD OF DIRECTORS
25 APRICOT STREET
STAFFORD VA 22554

Officer/Director/Trustee Four

BRITNI BURKS
MEMBER-AT-LARGE, BOARD OF DIRECTORS
25 APRICOT STREET
STAFFORD VA 22554

Officer/Director/Trustee Five

KATHRYN NESTLER
SECRETARY, BOARD OF DIRECTORS
25 APRICOT STREET
STAFFORD VA 22554

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/19
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 Yes
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 STEPHANIE SHOOK
Signature Title PRESIDENT, BOARD OF DIRECTORS
Signature Date 11/3/19

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