FORM 1023-EZ for QUEEN CITY 49ERS

Field Data
EIN 81-1244918
Case Number EO-2016053-000398
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QUEEN CITY 49ERS
Organization’s Mailing Address 2017 ROSEWATER LN
City INDIAN TRAIL
State NC
ZIP 28079
Accounting period End 12
Primary contact name KAMEKA LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAMEKA LEWIS
PRESIDENT
2017 ROSEWATER LN
INDIAN TRAIL NC 28079

Organization’s website QC49ERS.COM
Organization’s email QUEENCITY49ERS@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/27/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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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