FORM 1023-EZ for MEDFORD VOLLEYBALL BOOSTER CLUB

Field Data
EIN 27-2049862
Case Number EO-2015076-000131
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDFORD VOLLEYBALL BOOSTER CLUB
Organization’s Mailing Address N2082 STATE HWY 13
City MEDFORD
State WI
ZIP 54451
Accounting period End 12
Primary contact name CHAR BAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CATHY PERNSTEINER
PRESIDENT
W6708 CEDAR STREET
MEDFORD WI 54451

Officer/Director/Trustee Two

PATTI KLEMM
VICE PRESIDENT
N3891 COUNTY ROAD C
MEDFORD WI 54451

Officer/Director/Trustee Three

CHAR BAKER
SECRETARY/TREASURER
N2082 STATE HWY 13
MEDFORD WI 54451

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2014
Organization Incorporation State WI
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: No
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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