FORM 1023-EZ for CREELVIEW LACROSSE BOYS BOOSTER CLUB INC

Field Data
EIN 47-1477110
Case Number EO-2014267-000261
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CREELVIEW LACROSSE BOYS BOOSTER CLUB INC
Organization’s Mailing Address 1550 OWENS STORE RD
City CANTON
State GA
ZIP 30115
Accounting period End 7
Primary contact name TAMMY PUHALOVICH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAMMY PUHALOVICH
VICE PRESIDENT
1165 Hester Dr
Cumming GA 30028

Officer/Director/Trustee Two

BRAD LEWANDOWSKI
PRESIDENT
911 RAVENWOOD WAY
CANTON GA 30115

Officer/Director/Trustee Three

NANCY HERRINGTON
PRESIDENT
179 MOUNT MORIAH RD
BALLGROUND GA 30107

Officer/Director/Trustee Four

STEVE WOODRUFF
SECRETARY
192 SPRING LAKE LANE
CANTON GA 30115

Officer/Director/Trustee Five

SUSANNE EDWARDS
TREASURER
926 RAVENWOOD WAY
CANTON GA 30115

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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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