FORM 1023-EZ for GREENWICH HIGH SCHOOL SPORTS HALL OF FAME

Field Data
EIN 30-0792444
Case Number EO-2015201-000138
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GREENWICH HIGH SCHOOL SPORTS HALL OF FAME
Organization’s Mailing Address 47 PINE CREEK AVENUE
City FAIRFIELD
State CT
ZIP 06824
Accounting period End 12
Primary contact name PATRICK MEDIATE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATRICK MEDIATE
PRESIDENT
47 PINE CREEK AVENUE
FAIRFIELD CT 06824

Officer/Director/Trustee Two

JOSEPH MEDIATE
SECRETARY
530 ABBYWOOD DRIVE
ROSWELL GA 30075

Organization’s website GHSHALLOFFAME.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/2/2013
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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