FORM 1023-EZ for HENRY CLAY DANCE BOOSTERS INC

Field Data
EIN 83-1623875
Case Number EO-2018256-000472
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HENRY CLAY DANCE BOOSTERS INC
Organization’s Mailing Address 1016 STONECROP DRIVE
City LEXINGTON
State KY
ZIP 40509
Accounting period End 12
Primary contact name TENA ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL DAVIS
PRESIDENT
1016 STONECROP DRIVE
LEXINGTON KY 40509

Officer/Director/Trustee Two

SCARLETT BAILEY
VICE PRESIDENT
633 WINTER HILL LANE
LEXINGTON KY 40509

Officer/Director/Trustee Three

ALLISON LIST
SECRETARY
3368 PUEBLO COURT
LEXINGTON KY 40509

Organization’s website
Organization’s email JILLANDMICHAEL@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/23/18
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 MICHAEL DAVIS
Signature Title PRESIDENT
Signature Date 9/11/18

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