FORM 1023-EZ for 505 MASTERS WATER POLO CLUB

Field Data
EIN 85-2625184
Case Number EO-2021027-000153
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 505 MASTERS WATER POLO CLUB
Organization’s Mailing Address 2445 CONSUELO LN NW
City ALBUQUERQUE
State NM
ZIP 87104
Accounting period End 12
Primary contact name JESSICA PALACIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN BLAHA
PRESIDENT
2445 CONSUELO LANE NW
ALBUQUERQUE NM 87104

Officer/Director/Trustee Two

ALICA SIKORA
VICE PRESIDENT
4353 ALTURA VISTA LN
ALBUQUERQUE NM 87110

Officer/Director/Trustee Three

JESSICA PALACIO
CHIEF FINANCIAL OFFICER
1307 DARTMOUTH DR NE
ALBUQUERQUE NM 87106

Officer/Director/Trustee Four

SAMANTHA MORLEY
SECRETARY
237 HERMOSA DR NE
ALBUQUERQUE NM 87108

Officer/Director/Trustee Five

MARGARET GEORGE-DAVIS
DIRECTOR OF OPERATIONS
5501 KETTLE RD NW
ALBUQUERQUE NM 87120

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2020
Organization Incorporation State NM
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: 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 Yes
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) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSICA PALACIO
Signature Title CHIEF FINANCIAL OFFICER
Signature Date 12/7/2020

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