FORM 1023-EZ for EFFINGHAM SPORTSBACKERS INC

Field Data
EIN 81-0724399
Case Number EO-2016118-000285
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EFFINGHAM SPORTSBACKERS INC
Organization’s Mailing Address 122 E WASHINGTON
City EFFINGHAM
State IL
ZIP 62401
Accounting period End 12
Primary contact name CHRISTOPHER A KOESTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLES WHITE
DIRECTOR
11169 E RAVENWOOD COURT
EFFINGHAM IL 62401

Officer/Director/Trustee Two

CHRISTOPHER KOESTER
DIRECTOR
15975 N BLUEBIRD DRIVE
EFFINGHAM IL 62401

Officer/Director/Trustee Three

CHRISTOPHER KREKE
DIRECTOR
15096 N NAZARENE ROAD
SHUMWAY IL 62461

Officer/Director/Trustee Four

MANDY BUSHUR
DIRECTOR
4201 N 1100TH STREET
MASON IL 62443

Officer/Director/Trustee Five

STEVEN BONE
DIRECTOR
506 PARK HILLS DRIVE
EFFINGHAM IL 62401

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 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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