FORM 1023-EZ for LADY REBEL SPORTS CLUB

Field Data
EIN 20-0853983
Case Number EO-2019158-000271
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LADY REBEL SPORTS CLUB
Organization’s Mailing Address 110 CHASON LN
City WEST MONROE
State LA
ZIP 71291
Accounting period End 12
Primary contact name DAVID DALFIUME
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID DALFIUME
DIRECTOR
110 CHASON LN
WEST MONROE LA 71291

Officer/Director/Trustee Two

KIESSA EATON
DIRECTOR
100 CASTLE CREEK DR
WEST MONROE LA 71291

Officer/Director/Trustee Three

JENNIFER NICHOLS
DIRECTOR
220 ALTA MIRA DR
WEST MONROE LA 71291

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/04
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID DALFIUME
Signature Title DIRECTOR
Signature Date 6/5/19

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