FORM 1023-EZ for WARREN YOUTH BASKETBALL ASSOCIATION

Field Data
EIN 81-3469402
Case Number EO-2016270-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WARREN YOUTH BASKETBALL ASSOCIATION
Organization’s Mailing Address 5530 STATE ROUTE 339
City VINCENT
State OH
ZIP 45784
Accounting period End 12
Primary contact name ROB SHOTWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROB SHOTWELL
PRESIDENT
5530 STATE ROUTE 339
VINCENT OH 45784

Officer/Director/Trustee Two

STEPHANIE STARCHER
VICE PRESIDENT
65 CANTERBURY CT
BELPRE OH 45714

Officer/Director/Trustee Three

KATIE LEMLEY
TREASURER
73 SECOND ST
VINCENT OH 45784

Officer/Director/Trustee Four

RENEE SHOTWELL
SECRETARY
5530 STATE ROUTE 339
VINCENT OH 45784

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 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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