FORM 1023-EZ for MV BOYS CROSS COUNTRY BOOSTER CLUB

Field Data
EIN 81-2244776
Case Number EO-2016110-000208
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MV BOYS CROSS COUNTRY BOOSTER CLUB
Organization’s Mailing Address 4525 SNAIL LAKE BLVD
City SHOREVIEW
State MN
ZIP 55126
Accounting period End 12
Primary contact name SHAWN CARPENTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHAWN CARPENTER
DIRECTOR
4525 SNAIL LAKE BLVD
SHOREVIEW MN 55126

Officer/Director/Trustee Two

DIANE HESSINI
TREASURER
3 BLUEBIRD LANE
NORTH OAKS MN 55127

Officer/Director/Trustee Three

MICHELLE DELAUNE
MEMBER
5036 TURTLE LANE EAST
SHOREVIEW MN 55126

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/12/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 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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