FORM 1023-EZ for LOTZA FUN SUMMER CAMP

Field Data
EIN 47-1570405
Case Number EO-2014251-000623
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOTZA FUN SUMMER CAMP
Organization’s Mailing Address 1413 DREAM BRIDGE DR
City LAS VEGAS
State NV
ZIP 89144-1654
Accounting period End 12
Primary contact name JOHN KLUMBACH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DARREN SCHAFFER
PRESIDENT
1413 DREAM BRIDGE DR
LAS VEGAS NV 89144-1654

Officer/Director/Trustee Two

ROY MADISON
SECRETARY
1413 DREAM BRIDGE DR
LAS VEGAS NV 89144-1654

Officer/Director/Trustee Three

ROBERT KNIPES
TREASURER
1413 DREAM BRIDGE DR
LAS VEGAS NV 89144-1654

Officer/Director/Trustee Four

ALBERT VAN GORDON
DIRECTOR
1413 DREAM BRIDGE DR
LAS VEGAS NV 89144-1654

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/2014
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
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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