FORM 1023-EZ for LAKE FREDERICK VETERANS ASSOCIATION

Field Data
EIN 84-4233796
Case Number EO-2020014-000124
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE FREDERICK VETERANS ASSOCIATION
Organization’s Mailing Address 107 GROSBEAK CT
City LAKE FREDERICK
State VA
ZIP 22630-2262
Accounting period End 12
Primary contact name MARVIN DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARVIN DAVIS
DIRECTOR
107 GROSBEAK CT
LAKE FREDERICK VA 22630-2262

Officer/Director/Trustee Two

DALE DAVIS
DIRECTOR
116 TURNSTONE LANE
LAKE FREDERICK VA 22630-2262

Officer/Director/Trustee Three

LARRY MARSH
DIRECTOR
146 RUFFED GROUSE CT
LAKE FREDERICK VA 22630-2262

Officer/Director/Trustee Four

RICH GERVASONI
DIRECTOR
121 HARVESTER DR
LAKE FREDERICK VA 22630-2262

Officer/Director/Trustee Five

JIM HATCH
DIRECTOR
109 OSPREY DR
LAKE FREDERICK VA 22630-2262

Organization’s website
Organization’s email MDAVIS5219@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2019
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 MARVIN DAVIS
Signature Title DIRECTOR
Signature Date 1/12/2020

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