FORM 1023-EZ for OLD HICKORY CLUB

Field Data
EIN 82-4548921
Case Number EO-2018135-000357
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OLD HICKORY CLUB
Organization’s Mailing Address 313 OCELOT DR
City ARABI
State LA
ZIP 70032
Accounting period End 12
Primary contact name BLAKE LEJEUNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BLAKE LEJEUNE
PRESIDENT
313 OCELOT DR
ARABI LA 70032

Officer/Director/Trustee Two

ANDRE DOMINICK
SECRETARY TREASURER
309 OCELOT DRIVE
ARABI LA 70032

Officer/Director/Trustee Three

ROBERT SHAHINE
DIRECTOR
2313 LENA DR
CHALMETTE LA 70043

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/18
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B19 - Nonmonetary Support 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BLAKE LEJEUNE
Signature Title PRESIDENT
Signature Date 5/10/18

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