FORM 1023-EZ for COASTAL RENEGADES LACROSSE

Field Data
EIN 81-4623424
Case Number EO-2017003-000127
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COASTAL RENEGADES LACROSSE
Organization’s Mailing Address 104 SUTTON DRIVE
City CAPE CARTERET
State NC
ZIP 28584
Accounting period End 12
Primary contact name MATTHEW R DYMMEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY HOLT
PRESIDENT
104 SUTTON DRIVE
CAPE CARTERET NC 28584

Officer/Director/Trustee Two

MICHAEL FITZGERALD
DIRECTOR
180 SEA TRACE LANE
NEWPORT NC 28570

Officer/Director/Trustee Three

TARA HOBBS POWELL
SECRETARY
106 OSPREY COURT
NEWPORT NC 28570

Officer/Director/Trustee Four

MATTHEW DYMMEL
TREASURER
207 LARKIN STREET
MOREHEAD CITY NC 28557

Officer/Director/Trustee Five

CHARLES NEBRASKI
DIRECTOR
110 ANTLER DRIVE
NEWPORT NC 28570

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N66 - Tennis, Racquet Sports 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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