FORM 1023-EZ for LADY PATRIOTS LACROSSE BOOSTERS CLUB

Field Data
EIN 81-1151913
Case Number EO-2016081-000353
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LADY PATRIOTS LACROSSE BOOSTERS CLUB
Organization’s Mailing Address 7373 ROWENA ST
City SAN DIEGO
State CA
ZIP 92119
Accounting period End 8
Primary contact name SCOTT ELAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT ELAM
PRESIDENT
7373 ROWENA ST
SAN DIEGO CA 92119

Officer/Director/Trustee Two

ALEC RODNEY
TREASURER
7854 COMPASS LANE
SAN DIEG CA 92119

Officer/Director/Trustee Three

CHERYL IRICK
SECRETARY
5853 LOMOND DR
SAN DIEGO CA 92120

Officer/Director/Trustee Four

MIKE POLOTRAK
MEMBER AT LARGE
5874 REDGEMOOR DR
SAN DIEGO CA 92120

Organization’s website WWW.LADYPATRIOTSLACROSSE.COM
Organization’s email SCOTTGELAM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 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 Yes
One Third Support Gifts No
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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