FORM 1023-EZ for KAMIAKIN LACROSSE CLUB

Field Data
EIN 83-2755966
Case Number EO-2018347-000339
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KAMIAKIN LACROSSE CLUB
Organization’s Mailing Address 7123 W 9TH PLACE
City KENNEWICK
State WA
ZIP 99336
Accounting period End 6
Primary contact name RON HAVENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RON HAVENS
PRESIDENT
7123 W 9TH PLACE
KENNEWICK WA 99336

Officer/Director/Trustee Two

KRISTI MARTIN
VICE-PRESIDENT
106 SOUTH BERMUDA RD
KENNEWICK WA 99338

Officer/Director/Trustee Three

KAREN SORENSON
SECRETARY
8505 WEST 9TH PLACE
KENNEWICK WA 99336

Officer/Director/Trustee Four

TAMMI COLEMAN
TREASURER
110 SOUTH NEVADA STREET
KENNEWICK WA 99336

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/18
Organization Incorporation State WA
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: 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 RON HAVENS
Signature Title PRESIDENT
Signature Date 12/11/18

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