FORM 1023-EZ for FORESTHILL YOUTH SOCCER CLUB

Field Data
EIN 37-1944963
Case Number EO-2021056-000315
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORESTHILL YOUTH SOCCER CLUB
Organization’s Mailing Address PO BOX 192
City FORESTHILL
State CA
ZIP 95631
Accounting period End 12
Primary contact name THOMAS PAUL MUDD SR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS PAUL MUDD
PRESIDENT
20175 REDWOOD DR
FORESTHILL CA 95631

Officer/Director/Trustee Two

TATIANA EDSON
DIRECTOR VISE PRESIDENT
5651 TIMBERLAND DRIVE
FORESTHILL CA 95631

Officer/Director/Trustee Three

HIEN THI MEDIGOVICH
TREASURER
5445 HAPPY PINES DRIVE
FORESTHILL CA 95631

Officer/Director/Trustee Four

BRITTANY ADAMS
SECRETARY
21280 VINEWOOD DRIVE
FOERSTHILL CA 95631

Officer/Director/Trustee Five

SHAWN PAYNE
DIRECTOR BOARD COACH COORDINATOR
20850 SPRING GARDEN ROAD
FORESTHILL CA 95631

Organization’s website FORESTHILLYOUTHSOCCER.COM
Organization’s email FORESTHILLSOCCERCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name THOMAS PAUL MUDD
Signature Title PRESIDENT
Signature Date 1/7/2021

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