FORM 1023-EZ for FOREST PARK BASKETBALL CLUB INC

Field Data
EIN 46-4068844
Case Number EO-2014232-000104
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOREST PARK BASKETBALL CLUB INC
Organization’s Mailing Address 4981 EAST STATE ROAD 264
City FERDINAND
State IN
ZIP 47532-9474
Accounting period End 12
Primary contact name JENNIFER LUSK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM HARRIS
PRESIDENT
8502 NORTH CRYSTAL ROAD
DUBOIS IN 47527-9683

Officer/Director/Trustee Two

JENNIFER LUSK
VICE PRESIDENT
4981 EAST STATE ROAD 264
FERDINAND IN 47532-9474

Officer/Director/Trustee Three

SARA BETZ
SECTRETARY/TREASURER
3450 SOUTH 700 EAST
SAINT ANTHONY IN 47575-9623

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2013
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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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