FORM 1023-EZ for ROCKFORD LAX LACROSSE CLUB

Field Data
EIN 46-0766221
Case Number EO-2015156-000059
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROCKFORD LAX LACROSSE CLUB
Organization’s Mailing Address 2902 MCFARLAND ROAD SUITE 400
City ROCKFORD
State IL
ZIP 61107
Accounting period End 12
Primary contact name CRAIG P THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BOB WHITE
PRESIDENT/DIRECTOR
1708 OXFORD STREET
ROCKFORD IL 61103

Officer/Director/Trustee Two

CRAIG THOMAS
SECRETARY/DIRECTOR
810 HERITAGE WAY
BELVIDERE IL 61008

Officer/Director/Trustee Three

TRACEY KAST
TREASURER/DIRECTOR
1716 MELROSE STREET
ROCKFORD IL 61103

Officer/Director/Trustee Four

PETER SCORDATO
VICE PRESIDENT/DIRECTOR
4150 N PERRYVILLE ROAD
LOVES PARK IL 61111

Officer/Director/Trustee Five

JIM CORBETT
DIRECTOR
11204 INVERWAY
BELVIDERE IL 61008

Organization’s website ROCKFORDLAX.NET
Organization’s email ROCKFORDLAX.NET@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/2013
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
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 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 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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