FORM 1023-EZ for GRAND LAKE VIPERS

Field Data
EIN 82-3041967
Case Number EO-2017290-000247
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRAND LAKE VIPERS
Organization’s Mailing Address 455 NORTH PERRY STREET
City SAINT MARYS
State OH
ZIP 45885
Accounting period End 12
Primary contact name JAMIE WALLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMIE WALLEY
PRESIDENT
455 NORTH PERRY STREET
SAINT MARYS OH 45885

Officer/Director/Trustee Two

NICHOLAS WALLEY
TREASURER
455 NORTH PERRY STREET
SAINT MARYS OH 45885

Officer/Director/Trustee Three

JAMES EVERAGE
TRUSTEE
522 WEST NORTH STREET
SAINT MARYS OH 45885

Organization’s website
Organization’s email GLVIPERS@OUTLOOK.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
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 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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