FORM 1023-EZ for 18TH AVENUE SPORTS CLUB

Field Data
EIN 47-2857058
Case Number EO-2015048-000108
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 18TH AVENUE SPORTS CLUB
Organization’s Mailing Address 60 SETTLERS CT
City BEDFORD
State NH
ZIP 03110
Accounting period End 12
Primary contact name JASON SOUKUP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JASON SOUKUP
PRESIDENT
60 SETTLERS CT
BEDFORD NH 03110

Officer/Director/Trustee Two

THOMAS GRIFFITH
DIRECTOR
84 MORAINE ST
JAMAICA PLAIN MA 02130

Officer/Director/Trustee Three

KEVIN ONEAL
DIRECTOR
5104 SUMMIT HILL DRIVE
DALLAS TX 75287

Officer/Director/Trustee Four

BRYCE HALES
DIRECTOR
786 EAST 900 SOUTH
SALT LAKE CITY UT 84105

Officer/Director/Trustee Five

SAMUEL WHEATLEY
DIRECTOR
340 SOUTH 1300 EAST
SALT LAKE CITY UT 84102

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2015
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 Yes
One Third Support Gifts No
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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