FORM 1023-EZ for PUTNAM STORM LACROSSE TEAM

Field Data
EIN 81-4892249
Case Number EO-2017333-000483
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PUTNAM STORM LACROSSE TEAM
Organization’s Mailing Address 1143 HICKORY MILLS DRIVE
City HURRICANE
State WV
ZIP 25526
Accounting period End 12
Primary contact name REBECCA H SIZEMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA SIZEMORE
PRESIDENT
1143 HICKORY MILLS DRIVE
HURRICANE WV 25526

Officer/Director/Trustee Two

JILL NEWMAN
VICE PRESIDENT
161 LESLIE PLACE
SCOTT DEPOT WV 25560

Officer/Director/Trustee Three

AUTUMN TUSING
SECRETARY/TREASURER
438 COW CREEK
HURRICANE WV 25526

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/2017
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
Organization’s purpose Charitable: Yes
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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