FORM 1023-EZ for BROWNSBURG YOUTH LACROSSE

Field Data
EIN 46-3961995
Case Number EO-2015196-000140
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROWNSBURG YOUTH LACROSSE
Organization’s Mailing Address 8430 LOCKERBIE DR
City BROWNSBURG
State IN
ZIP 46112
Accounting period End 12
Primary contact name JASON KOLES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JASON KOLES
PRESIDENT
8430 LOCKERBIE DR
BROWNSBURG IN 46112

Officer/Director/Trustee Two

JOHN DOSS
DIR OF PLAYER DEVELOPMENT
10973 GOLF VIEW DR
INDIANAPOLIS IN 46234

Officer/Director/Trustee Three

BILL BEHREND
VP - HIGH SCHOOL
LESLEY LN
BROWNSBURG IN 46112

Officer/Director/Trustee Four

JOHN TAYLOR
VP - YOUTH
761 NORTHAMPTON ROW
DANVILLE IN 46122

Officer/Director/Trustee Five

RICH HOWARD
SECRETARY
384 THORNBURG PARKWAY
BROWNSBURG IN 46112

Organization’s website WWW.BROWNSBURGLACROSSE.COM
Organization’s email BROWNSBURGLAX@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2013
Organization Incorporation State IN
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: Yes
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 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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