FORM 1023-EZ for SHOSHONE BOOSTER CLUB

Field Data
EIN 47-4574767
Case Number EO-2015316-000249
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHOSHONE BOOSTER CLUB
Organization’s Mailing Address PO BOX 311
City SHOSHNE
State ID
ZIP 83352
Accounting period End 12
Primary contact name TERA PERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TERA PERRY
PRESIDENT
PO BOX311
SHOSHONE ID 83352

Officer/Director/Trustee Two

JENNIFER PATTERSON
SECRETARY
PO BOX 311
SHOSHONE ID 83352

Officer/Director/Trustee Three

KARMA FITZGERALD
VICE PRESIDENT
PO BOX 311
SHOSHONE ID 83352

Officer/Director/Trustee Four

NANCY RODRIGUEZ
TREASURE
PO BOX 311
SHOSHONE ID 83352

Officer/Director/Trustee Five

OSCAR RODRIGUEZ
TREASURE
PO BOX 311
SHOSHONE ID 83352

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2015
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 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
Signature Title
Signature Date

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