FORM 1023-EZ for SHADOW GUARDIANS LE MC

Field Data
EIN 83-4696831
Case Number EO-2019149-000114
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHADOW GUARDIANS LE MC
Organization’s Mailing Address 3225 CHARING CROSS ROAD
City MIDLOTHIAN
State TX
ZIP 76065
Accounting period End 12
Primary contact name PETER KOZAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PETER KOZAK
VP
3225 CHARING CROSS RD
MIDLOTHIAN TX

Officer/Director/Trustee Two

KEVIN JONES
PRESIDENT
300 MARINA DR
LAKE DALLAS TX 75065

Officer/Director/Trustee Three

BRANDON KROLCZTK
LTN ARMS
6417CLAIRFIELD STREET
CORPUS CHRISTI TX 77814

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/9/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 PETER KOZAK
Signature Title VP
Signature Date 5/27/19

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