FORM 1023-EZ for MID VALLEY YOUTH SOCCER LEAGUE INC

Field Data
EIN 81-2034680
Case Number EO-2018232-000247
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MID VALLEY YOUTH SOCCER LEAGUE INC
Organization’s Mailing Address 125 E ACORN HILL DR
City OLYPHANT
State PA
ZIP 18447
Accounting period End 12
Primary contact name BRIAN WITZKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID PATCHCOSKI
PRESIDENT
207 WHITE OAK DR
OLYPHANT PA 18447

Officer/Director/Trustee Two

ROBERT JUDGE
VICE PRESIDENT
100 FERN HILL DR
OLYPHANT PA 18447

Officer/Director/Trustee Three

MARCELO DESOUSA
TREASURER
130 VAUGHN ST
THROOP PA 18512

Officer/Director/Trustee Four

STACY KANE
SECRETARY
725 ALBERT ST
DICKSON CITY PA 18519

Officer/Director/Trustee Five

BRIAN WITZKE
PLAYER AGENT
125 E ACORN HILL DR
OLYPHANT PA 18447

Organization’s website MIDVALLEYYOUTHSOCCER.COM
Organization’s email MIDVALLEYYOUTHSOCCER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/14/16
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer 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 BRIAN WITZKE
Signature Title PLAYER AGENT
Signature Date 8/16/18

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