FORM 1023-EZ for SHORELINE SPORTS FOUNDATION

Field Data
EIN 47-1655529
Case Number EO-2014239-000123
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHORELINE SPORTS FOUNDATION
Organization’s Mailing Address 742 N 200TH ST
City SHORELINE
State WA
ZIP 98133
Accounting period End 12
Primary contact name KEITH NELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEITH NELSON
EXECUTIVE DIRECTOR
742 N 200TH ST
SHORELINE WA 98133

Officer/Director/Trustee Two

DICK SHOEMAKER
CHAIRMAN OF THE BOARD
17412 32ND AVE NE
LAKE FOREST PARK WA 98155

Officer/Director/Trustee Three

EMILY GALLAGHER
BOARD MEMBER PROGRAM DESIGN
3841 NE 155TH STREET
SHORELINE WA 98155

Officer/Director/Trustee Four

STEVE LEE
BOARD MEMBER TREASURER
17747 25TH AVE NE
SHORELINE WA 98155

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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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