FORM 1023-EZ for STAY IN THE GAME FOUNDATION

Field Data
EIN 83-2612379
Case Number EO-2019043-000091
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STAY IN THE GAME FOUNDATION
Organization’s Mailing Address 2129 1/2 E FLORIDA ST
City LONG BEACH
State CA
ZIP 90814
Accounting period End 12
Primary contact name JOHN CARROLL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN CARROLL
DIRECTOR
2129 1/2 E FLORIDA ST
LONG BEACH CA 90814

Officer/Director/Trustee Two

HOLLY DORN
DIRECTOR
902 BUNKER ST
WOODSTOCK IL 60098

Officer/Director/Trustee Three

JEFF FERRARIO
DIRECTOR
4241 EMERALD CIRCLE
CYPRESS CA 90630

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/17/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 HOLLY DORN
Signature Title DIRECTOR
Signature Date 2/10/19

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