FORM 1023-EZ for MOUNTAIN RIDGE LACROSSE

Field Data
EIN 47-1908662
Case Number EO-2014295-000101
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNTAIN RIDGE LACROSSE
Organization’s Mailing Address 6978 WEST AURORA DRIVE
City GLENDALE
State AZ
ZIP 85308
Accounting period End 8
Primary contact name JEFF MCMAINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEFFREY MCMAINS
PRESIDENT
6978 WEST AURORA DRIVE
GLENDALE AZ 85308

Officer/Director/Trustee Two

JAN TAVRTYZKY
DIRECTOR
22375 NORTH 65TH AVE
GLENDALE AZ 85310

Officer/Director/Trustee Three

DAVID GARTEN
DIRECTOR
5734 WEST MONONA DRIVE
GLENDALE AZ 85308

Officer/Director/Trustee Four

KARA SCHRIPSEMA
DIRECTOR
25429 NORTH MOON BLOSSUM LN
PHOENIX AZ 85083

Organization’s website
Organization’s email JEFFMCMAINS@COX.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2014
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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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