FORM 1023-EZ for HIGHLAND LACROSSE CLUB INC

Field Data
EIN 38-4044013
Case Number EO-2017233-000297
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIGHLAND LACROSSE CLUB INC
Organization’s Mailing Address 2223 OSAGE TRAIL
City SHARON TOWNSHIP
State OH
ZIP 44281
Accounting period End 6
Primary contact name MARK PRZYBYSZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK PRZYBYSZ
PRESIDENT TREASURER
2223 OSAGE TRAIL
SHARON TOWNSHIP OH 44281

Officer/Director/Trustee Two

IVAN BAKER
VICE PRESIDENT
2223 OSAGE TRAIL
SHARON TOWNSHIP OH 44281

Officer/Director/Trustee Three

AUDRA BEERS
SECRETARY
2223 OSAGE TRAIL
SHARON TOWNSHIP OH 44281

Officer/Director/Trustee Four

BEVERLY PRZYBYSZ
CONSULTANT
2223 OSAGE TRAIL
SHARON TOWNSHIP OH 44281

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/24/2017
Organization Incorporation State OH
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: 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 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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