FORM 1023-EZ for LADY VIPERS RUGBY CLUB

Field Data
EIN 47-4989099
Case Number EO-2018297-000295
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LADY VIPERS RUGBY CLUB
Organization’s Mailing Address 9737 SOUTH 1600 WEST
City SOUTH JORDAN
State UT
ZIP 84095
Accounting period End 12
Primary contact name PATTIE S CHRISTENSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEANNIE GAMBLE
TRUSTEE
736 CANYON ROAD
OGDEN UT 84404

Officer/Director/Trustee Two

ELAINE CLARK
TRUSTEE
276 EDITH AVE
SALT LAKE CITY UT 84111

Officer/Director/Trustee Three

DAVID SHELLEDY
TRUSTEE
9737 SOUTH 1600 WEST
SOUTH JORDAN UT 84095

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/15
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID SHELLEDY
Signature Title TRUSTEE
Signature Date 10/22/18
EIN 47-4989099
Case Number EO-2015253-000437
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LADY VIPERS RUGBY CLUB
Organization’s Mailing Address 9737 SOUTH 1600 WEST
City SOUTH JORDAN
State UT
ZIP 84095
Accounting period End 12
Primary contact name PATTIE S CHRISTENSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEANNIE GAMBLE
TRUSTEE
736 CANYON ROAD
OGDEN UT 84404

Officer/Director/Trustee Two

ELAINE CLARK
TRUSTEE
276 EDITH AVE
SALT LAKE CITY UT 84111

Officer/Director/Trustee Three

DAVID SHELLEDY
TRUSTEE
9737 SOUTH 1600 WEST
SOUTH JORDAN UT 84095

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2015
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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 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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