FORM 1023-EZ for FC MONTOUR SOCCER CLUB

Field Data
EIN 87-2195293
Case Number EO-2021230-000428
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FC MONTOUR SOCCER CLUB
Organization’s Mailing Address 120 SAMPSELL RD
City MONTGOMERY
State PA
ZIP 17752
Accounting period End 12
Primary contact name JUSTIN JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUSTIN JONES
PRESIDENT
120 SAMPSELL RD
MONTGOMERY PA 17752

Officer/Director/Trustee Two

MICHEAL BENNETT
VICE PRESIDENT
2629 STATE RD 864
MONTOURSVILLE PA 17754

Officer/Director/Trustee Three

DAVID FORTIN
TREASURER
1122 CHERRY ST
MONTOURSVILLE PA 17754

Officer/Director/Trustee Four

DAVID BOYLE
FUNDRAISING COORDINATOR
174 EVERGREEN TERRACE
MONTOURSVILLE PA 17754

Officer/Director/Trustee Five

DONALD JACOPETTI
SECRETARY-REGISTRAR
311 KATIE LN
MONTOURSVILLE PA 17754

Organization’s website NOT APPLICAPBLE
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2010
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W11 - 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID FORTIN
Signature Title TREASURER
Signature Date 8/17/2021

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