FORM 1023-EZ for PINELLAS LACROSSE ALLIANCE INC

Field Data
EIN 82-3988857
Case Number EO-2018106-000636
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PINELLAS LACROSSE ALLIANCE INC
Organization’s Mailing Address 28100 US HIGHWAY 19 N SUITE 300
City CLEARWATER
State FL
ZIP 33761
Accounting period End 12
Primary contact name APRIL RICHARDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL METZHEISER
DIRECTOR
28100 US HIGHWAY 19 N SUITE 300
CLEARWATER FL 33761

Officer/Director/Trustee Two

XAVIER PUJOL
DIRECTOR
28100 US HIGHWAY 19 N SUITE 300
CLEARWATER FL 33761

Officer/Director/Trustee Three

KERRY DANO
DIRECTOR
28100 US HIGHWAY 19 N SUITE 300
CLEARWATER FL 33761

Officer/Director/Trustee Four

JOHN MATZKE
DIRECTOR
28100 US HIGHWAY 19 N SUITE 300
CLEARWATER FL 33761

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 PAUL METZHEISER
Signature Title DIRECTOR
Signature Date 4/11/18

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