FORM 1023-EZ for LADY CHIEFS SOCCER BOOSTER CLUB

Field Data
EIN 82-2515337
Case Number EO-2017279-000196
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LADY CHIEFS SOCCER BOOSTER CLUB
Organization’s Mailing Address 155 JERI DR
City MOORESBURG
State TN
ZIP 37811
Accounting period End 7
Primary contact name CONSTANCE COLSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SELENA BLACKETER
PRESIDENT
155 JERI DR
MOORESBURG TN 37811

Officer/Director/Trustee Two

NATASHA STORY
VP
308 LOCUST ST
ROGERSVILLE TN 37857

Officer/Director/Trustee Three

CRAIG BELCHER
SEC
739 SANDY VALLEY RD
ROGERSVILLE TN 37857

Officer/Director/Trustee Four

AMY LINKOUS
CHAIR
725 BRUMMITT ST
ROGERSVILLE TN 37857

Officer/Director/Trustee Five

CONSTANCE COLSON
CPA
PO BOX 1477
MORRISTOWN TN 37816

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 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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