FORM 1023-EZ for LIBERTY HIGH SCHOOL SPORTS HALL OF FAME

Field Data
EIN 31-1521391
Case Number EO-2018109-000309
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIBERTY HIGH SCHOOL SPORTS HALL OF FAME
Organization’s Mailing Address 59 CAMELOT CT
City CANFIELD
State OH
ZIP 44406
Accounting period End 12
Primary contact name ELAINE JACOBS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELAINE JACOBS
PRESIDENT - PRO TEMP
59 CAMELOT CT
CANFIELD OH 44406

Officer/Director/Trustee Two

KIKI VLAJKOVICH
SECRETARY - PRO TEMP
60-2 MONTGOMERY DRIVE
CANFIELD OH 44406

Officer/Director/Trustee Three

DAVID DULL
TREASURER
330 WARNER ROAD
HUBBARD OH 44425

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/98
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B25 - Secondary, High School
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name ELAINE JACOBS
Signature Title PRESIDENT - PRO TEMP
Signature Date 4/15/18

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