FORM 1023-EZ for MIDD-WEST FOOTBALL ASSOCIATION

Field Data
EIN 26-0817044
Case Number EO-2019130-000158
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIDD-WEST FOOTBALL ASSOCIATION
Organization’s Mailing Address PO BOX 95
City BEAVER SPRINGS
State PA
ZIP 17812
Accounting period End 12
Primary contact name TIM ANDRETTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMIE KLINE
PRESIDENT
667 FAIRVIEW RD
MCCLURE PA 17841

Officer/Director/Trustee Two

TIM GROVER
VICE PRESIDENT
122 DECKER TREE FARM LN
MIDDLEBURG PA 17842

Officer/Director/Trustee Three

TIM ANDRETTA
SECRETARY
348 FIR AVE
MIDDLEBURG PA 17842

Officer/Director/Trustee Four

JOLENE FULTZ
TREASURER
4857 RIDGE RD
BEAVER SPRINGS PA 17812

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/07
Organization Incorporation State PA
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: Yes
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 Yes
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name TIM ANDRETTA
Signature Title SECRETARY
Signature Date 5/8/19

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