FORM 1023-EZ for SPACE COAST SLED HOCKEY INC

Field Data
EIN 84-2537830
Case Number EO-2019212-000278
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SPACE COAST SLED HOCKEY INC
Organization’s Mailing Address 3421 CRAGGY BLUFF PL
City COCOA
State FL
ZIP 32926
Accounting period End 6
Primary contact name DAMIEN RICHARDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWN EISING
P
618 SUGAR PINE DR
WEST MELBOURNE FL 32904

Officer/Director/Trustee Two

BILL CORBETT
VP
6985 BUCKHORN TRAIL
ST CLOUD FL 34771

Officer/Director/Trustee Three

DEBRA LUCAS
T
1360 MAHANEY PL
MELBOURNE FL 32940

Officer/Director/Trustee Four

LEE SKINNER
SEC
4145 EOLA AVE
TITUSVILLE FL 32796

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/24/19
Organization Incorporation State FL
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: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 LEE SKINNER
Signature Title SEC
Signature Date 7/29/19

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