FORM 1023-EZ for FORT ZUMWALT WEST INLINE HOCKEY INC

Field Data
EIN 82-3889971
Case Number EO-2018032-000177
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORT ZUMWALT WEST INLINE HOCKEY INC
Organization’s Mailing Address 401 CHURCH STREET SUITE 303
City OFALLON
State MO
ZIP 63366
Accounting period End 12
Primary contact name JAY TRUDEAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN COHEN
PRESIDENT
124 HENRIETTA COURT
OFALLON MO 63368

Officer/Director/Trustee Two

JAY TRUDEAU
TREASURER
189 SNAKE RIVER DRIVE
OFALLON MO 63368

Officer/Director/Trustee Three

GREG PAGUGA
SECRETARY
6913 EMMONS DRIVE
OFALLON MO 63368

Officer/Director/Trustee Four

WENDY MCGUIRE
VICE PRESIDENT OF HOCKEY DEV
2001 MOONDANCE DRIVE
OFALLON MO 63368

Officer/Director/Trustee Five

CHRIS VAN GELS
DIRECTOR OF TEAM COACHES
1022 BROOK MONT
OFALLON MO 63366

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/4/18
Organization Incorporation State MO
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRIAN COHEN
Signature Title PRESIDENT
Signature Date 1/30/18

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