FORM 1023-EZ for LANCERS BOYS SOCCER BOOSTER CLUB

Field Data
EIN 81-3861714
Case Number EO-2016263-000340
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LANCERS BOYS SOCCER BOOSTER CLUB
Organization’s Mailing Address 13030 CARTERS HILL CT
City CHESTERFIELD
State VA
ZIP 23838-3022
Accounting period End 6
Primary contact name LAURA HENRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURA HENRY
PRESIDENT
13030 CARTERS HILL CT
CHESTERFIELD VA 23838-3022

Officer/Director/Trustee Two

THOMAS TURNER
VICE PRESIDENT
9118 PRINCE JAMES TURN
CHESTERFIELD VA 23832

Officer/Director/Trustee Three

PATRICIA WEGRZYNOWICZ
MEMBERSHIP DIRECTOR
11255 ASCOT DR
MIDLOTHIAN VA 23112

Officer/Director/Trustee Four

MICHAEL KEATTS
TREASURER
8524 EASTON RIDGE
CHESTERFIELD VA 23832

Officer/Director/Trustee Five

ERICA DEAN
SECRETARY
12939 SINGER ROAD
MIDLOTHIAN VA 23112

Organization’s website
Organization’s email LANCERBOOSTERS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/14/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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