FORM 1023-EZ for TRICAJUNS TRIATHLON CLUB

Field Data
EIN 47-4727099
Case Number EO-2015292-000315
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRICAJUNS TRIATHLON CLUB
Organization’s Mailing Address 209 STONEBURG DR
City DUSON
State LA
ZIP 70529
Accounting period End 3
Primary contact name MONIQUE KOLL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MONIQUE KOLL
PRESIDENT
209 STONEBURG DR
DUSON LA 70529

Officer/Director/Trustee Two

AMY BOUDREAUX
VICE PRESIDENT
201 PRESCOTT BLVD NO 1211
YOUNGSVILLE LA 70592

Officer/Director/Trustee Three

DANE DEVALCOURT
SECRETARY
2334 HWY 93
CARENCRO LA 70520

Officer/Director/Trustee Four

LISA BELL
TREASURER
1216 LA RUE DE BROUSSARD
NEW IBERIA LA 70560

Officer/Director/Trustee Five

TOMMY BELL
DIRECTOR
1216 LA RUE DE BROUSSARD
NEW IBERIA LA 70560

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/19/2015
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
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 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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