FORM 1023-EZ for BROOKSIDE LACROSSE ASSOCATION

Field Data
EIN 81-0992880
Case Number EO-2016273-000392
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROOKSIDE LACROSSE ASSOCATION
Organization’s Mailing Address 5527 CENTRAL ST
City KANSAS CITY
State MO
ZIP 64113
Accounting period End 12
Primary contact name GREG GOSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GREGORY GOSS
PRESIDENT
5527 CENTRAL ST
KANSAS CITY MO 64113

Officer/Director/Trustee Two

JOHN CUSICK
VICE PRESIDENT
1287 W 71ST TERRACE
KANSASCCITY MO 64114

Officer/Director/Trustee Three

CHRIS BREWSTER
TREASURER
5736 GRAND
KANSAS CITY MO 64113

Organization’s website BROOKSIDELACROSSE.ORG
Organization’s email GOSS5527@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/2016
Organization Incorporation State MO
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: Yes
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 No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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