FORM 1023-EZ for BROOKVILLE RAIDERS ROUNDBALL CLUB

Field Data
EIN 20-5222749
Case Number EO-2017293-000294
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROOKVILLE RAIDERS ROUNDBALL CLUB
Organization’s Mailing Address PO BOX 232
City BROOKVILLE
State PA
ZIP 15825
Accounting period End 6
Primary contact name LARA MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE CABLE
PRESIDENT
19 WATERFORD PIKE
BROOKVILLE PA 15825

Officer/Director/Trustee Two

REBECCA PARK
TREASURER
PO BOX 134 208 STATE STREET
SUMMERVILLE PA 15864

Officer/Director/Trustee Three

AMY POWELL
SECRETARY
1679 FULLER ROAD
BROOKVILLE PA 15825

Officer/Director/Trustee Four

BETH KETH
BOYS VICE PRESIDENT
740 SNYDER ROAD
BROOKVILLE PA 15825

Officer/Director/Trustee Five

MICHELLE LINGENFELTER
GIRLS VICE PRESIDENT
134 PINE STREET
BROOKVILLE PA 15825

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/2006
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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 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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