FORM 1023-EZ for HARDIN NORTHERN BOOSTERS

Field Data
EIN 46-4187438
Case Number EO-2014220-000219
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HARDIN NORTHERN BOOSTERS
Organization’s Mailing Address 11589 STATE ROUTE 81
City DOLA
State OH
ZIP 45810
Accounting period End 6
Primary contact name DOUG ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOUG ROBERTS
PRESIDENT
10751 TOWNSHIP ROAD 135
KENTON OH 43326

Officer/Director/Trustee Two

JOE HOELZLE
SECRETARY/TREASURER
2824 COUNTY ROAD 135
DOLA OH 45835

Officer/Director/Trustee Three

SALLY HENRICK
VICE-PRESIDENT
655 EAST MARION STREET
MT. VICTORY OH 43340

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/2012
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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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