FORM 1023-EZ for MAYFIELD 650 WATER POLO CLUB

Field Data
EIN 82-3586625
Case Number EO-2018068-000229
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAYFIELD 650 WATER POLO CLUB
Organization’s Mailing Address 1796 HAMILTON AVE
City PALO ALTO
State CA
ZIP 94303-3005
Accounting period End 12
Primary contact name DOUGLAS STOTLAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS STOTLAND
PRESIDENT
1796 HAMILTON AVE
PALO ALTO CA 94303-3005

Officer/Director/Trustee Two

RODERICK ROWELL
TREASURER
2389 RAMONA ST
PALO ALTO CA 94301-4132

Officer/Director/Trustee Three

LAURA LINDSTROM
SECRETARY
1825 PARK BLVD
PALO ALTO CA 94306-1112

Organization’s website WWW.650WATERPOLO.ORG
Organization’s email 650WATERPOLO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/17
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
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 Yes
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 DOUGLAS STOTLAND
Signature Title PRESIDENT
Signature Date 3/7/18

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