FORM 1023-EZ for LAKE CATHOLIC COUGAR WRESTLING CLUB

Field Data
EIN 47-2580084
Case Number EO-2015007-000293
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE CATHOLIC COUGAR WRESTLING CLUB
Organization’s Mailing Address 2164 KIMBERLY COURT
City WICKLIFFE
State OH
ZIP 44092
Accounting period End 12
Primary contact name SCOTT HIVNOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT HIVNOR
HEAD COACH
2164 KIMBERLY CT
WICKLIFFE OH 44092

Officer/Director/Trustee Two

BRIAN BOLEY
OFFICER
7575 ALLEGHENY
MENTOR OH 44060

Officer/Director/Trustee Three

TINA HIVNOR
OFFICER
2164 KIMBERLY CT
WICKLIFFE OH 44092

Officer/Director/Trustee Four

MELANIE SZEP
OFFICER
12117 BEAN ROAD
CHARDON OH 44024

Officer/Director/Trustee Five

ERIK LAKIA
OFFICER
28428 FOREST ROAD
WILLOWICK OH 44095

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2014
Organization Incorporation State OH
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: 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
Signature Title
Signature Date

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