FORM 1023-EZ for DMV FC INC

Field Data
EIN 81-0916846
Case Number EO-2018302-000326
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DMV FC INC
Organization’s Mailing Address 4223 EVERGREEN LANE
City ANNANDALE
State VA
ZIP 22003
Accounting period End 12
Primary contact name NADIR MOUMEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NADIR MOUMEN
PRESIDENT
4223 EVERGREEN LANE
ANNANDALE VA 22003

Officer/Director/Trustee Two

BRENT LEIBA
TREASURER
4223 EVERGREEN LANE
ANNANDALE VA 22003

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/23/15
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 Yes
Correctness Declaration Yes
Signature Name NADIR MOUMEN
Signature Title PRESIDENT
Signature Date 10/25/18
EIN 81-0916846
Case Number EO-2016004-000355
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DMV FC INC
Organization’s Mailing Address 4223 EVERGREEN LANE
City ANNANDALE
State VA
ZIP 22003
Accounting period End 12
Primary contact name NADIR MOUMEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NADIR MOUMEN
DIRECTOR
4223 EVERGREEN LANE
ANNANDALE VA 22003

Officer/Director/Trustee Two

TODD HAMLIN
DIRECTOR
25098 GREEN MOUNTAIN TERRACE
ALDIE VA 20105

Officer/Director/Trustee Three

BRENT LEIBA
DIRECTOR
4223 EVERGREEN LANE
ANNANDALE VA 22003

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/23/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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