FORM 1023-EZ for VANCOUVER YOUTH LACROSSE

Field Data
EIN 46-3017665
Case Number EO-2018274-000274
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VANCOUVER YOUTH LACROSSE
Organization’s Mailing Address 9208 NW HWY 99 STE 108-357
City VANCOUVER
State WA
ZIP 98665
Accounting period End 12
Primary contact name RYAN STEVENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVE HUBBERTS
PRESIDENT
9208 NE HWY 99 STE 107-357
VANCOUVER WA 98665

Officer/Director/Trustee Two

BRETT RANKIN
VICE PRESIDENT
9208 NE HWY 99 STE 107-357
VANCOUVER WA 98665

Officer/Director/Trustee Three

KATRINA TULLIS
SECRETARY
9208 NE HWY 99 STE 107-357
VANCOUVER WA 98665

Officer/Director/Trustee Four

LEXY HUBBERTS
TREASURER
9208 NE HWY 99 STE 107-357
VANCOUVER WA 98665

Organization’s website HTTP://CCYLAX.ORG/
Organization’s email CCYLAX@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/14
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVE HUBBERTS
Signature Title PRESIDENT
Signature Date 9/27/18
EIN 46-3017665
Case Number EO-2014223-000222
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VANCOUVER YOUTH LACROSSE
Organization’s Mailing Address 10710 NE 38TH AVE
City VANCOUVER
State WA
ZIP 98686
Accounting period End 12
Primary contact name JILL JAHNKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NICK UNDERLAND
PRESIDENT
10710 NE 38TH AVE
VANCOUVER WA 98686

Officer/Director/Trustee Two

JIM ROEPER
VICE PRESIDENT
130 NW 49TH CIR
VANCOUVER WA 98663

Officer/Director/Trustee Three

ANGIE SCHILLER
SECRETARY
104 NW 148TH ST
VANCOUVER WA 98685

Officer/Director/Trustee Four

JILL JAHNKE
TREASURER
1204 NW 148TH CIR
VANCOUVER WA 98685

Organization’s website WWW.VANCOUVERYOUTHLACROSSE.COM
Organization’s email VANCOUVERYOUTHLAX@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, 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 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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