FORM 1023-EZ for CENTRAL VIRGINIA PICKLEBALL CLUB

Field Data
EIN 47-5632952
Case Number EO-2015365-000166
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CENTRAL VIRGINIA PICKLEBALL CLUB
Organization’s Mailing Address 109 VINCENNES ROAD
City CHARLOTTESVILLE
State VA
ZIP 22911
Accounting period End 12
Primary contact name GENE RABOIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LESLEY HAMILTON
PRESIDENT
109 VINCENNES ROAD
CHARLOTTESVILLE VA 22911

Officer/Director/Trustee Two

RUEBEN MONTOYA
VICE PRESIDENT
785 COUNTRY GREEN ROAD
CHARLOTTESVILLE VA 22903

Officer/Director/Trustee Three

GENE RABOIS
TREASURER
95 PRESTWOOD DRIVE
RUCKERSVILLE VA 22968-3097

Officer/Director/Trustee Four

ROBIN KUZEN
SECRETARY
848 SAINT CHARLES AVENUE
CHARLOTTESVILLE VA 22902-4004

Organization’s website WWW.CENTRALVIRGINIAPICKLEBALL.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2015
Organization Incorporation State VA
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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