FORM 1023-EZ for TOPSAIL YOUTH LACROSSE ASSOCIATION

Field Data
EIN 30-0788503
Case Number EO-2016162-000237
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TOPSAIL YOUTH LACROSSE ASSOCIATION
Organization’s Mailing Address PO BOX 176
City HAMPSTEAD
State NC
ZIP 28443
Accounting period End 7
Primary contact name DEREK COHEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRIS PARKS
PRESIDENT
205 STARGAZER CT
HAMPSTEAD NC 28443

Officer/Director/Trustee Two

KRISTEN CASE
OFFICER
76 NORTHERN ESCAPE WAY
HAMPSTEAD NC 28443

Officer/Director/Trustee Three

JACKIE SESSOMS
SECRETARY
143 CORNEL LANE
HAMPSTEAD NC 28443

Officer/Director/Trustee Four

DEREK COHEN
TREASURER
121 FAIRYTALE LANE
SURF CITY NC 28445

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/2013
Organization Incorporation State NC
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
Signature Title
Signature Date

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