FORM 1023-EZ for RANDY CARLSON MEMORIAL TOURNAMENT
| Field | Data |
|---|---|
| EIN | 84-3350106 |
| Case Number | EO-2020034-000522 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | RANDY CARLSON MEMORIAL TOURNAMENT |
| Organization’s Mailing Address | 275 WHITE PINE ROAD |
| City | DUBOIS |
| State | PA |
| ZIP | 15801 |
| Accounting period End | 12 |
| Primary contact name | SUMMER ANDERSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SUMMER ANDERSON
CO-CHAIR/TREASURER
275 WHITE PINE ROAD
DU BOIS PA 15801
Officer/Director/Trustee Two
ROBERT ANDERSON
CO-CHAIR
275 WHITE PINE ROAD
DUBOIS PA 15801
Officer/Director/Trustee Three
TIM HERMAN
SECRETARY
38 PENNSYLVANIA AVENUE
BROOKVILLE PA 15825
Officer/Director/Trustee Four
JOE BUSSARD
DIRECTOR OF COMMUNITY
505 GRANT STREET
REYNOLDSVILLE PA 15851
Officer/Director/Trustee Five
BRIAN ANDERSON
XHL REPRESENTATIVE
137 ANDERSON DRIVE
FALLS CREEK PA 15840
| Organization’s website | HTTPS://WWW.XHLHOCKEY.NET/COPY-OF-XHL-SCHEDULE |
|---|---|
| Organization’s email | |
| Organization Incorporated | |
| Organization trust | Yes |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/26/2019 |
| Organization Incorporation State | PA |
| 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: 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 | SUMMER ANDERSON |
| Signature Title | CO-CHAIR/TREASURER |
| Signature Date | 2/1/2020 |
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