FORM 1023-EZ for MOUNTAIN VIEW MENS LACROSSE BOOSTERCLUB INC

Field Data
EIN 81-3646547
Case Number EO-2016285-000160
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNTAIN VIEW MENS LACROSSE BOOSTERCLUB INC
Organization’s Mailing Address 2461 LANCE RIDGE WAY
City BUFORD
State GA
ZIP 30519
Accounting period End 6
Primary contact name TRAVIS BURROUGHS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES HURMENCE
PRESIDENT
2461 LANCE RIDGE WAY
BUFORD GA 30519

Officer/Director/Trustee Two

JAMES MURPHY
VICE PRESIDENT
2164 LENA CARTER ROAD
LAWRENCEVILLE GA 30043

Officer/Director/Trustee Three

VIRGINIA HURMENCE
CO-TREASURER
2461 LANCE RIDGE WAY
BUFORD GA 30519

Officer/Director/Trustee Four

CHRISTIE ROSS
CO-TREASURER
5071 STONE MOSS WAY
HOSCHTON GA 30548

Officer/Director/Trustee Five

KRISTAN SAWYER
SECRETARY
4872 JACOBS COVE POINTE
BUFORD GA 30519

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 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
Signature Title
Signature Date

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