FORM 1023-EZ for GULF COAST SWIM CLUB BOOSTER CLUB

Field Data
EIN 84-4566977
Case Number EO-2020037-000253
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GULF COAST SWIM CLUB BOOSTER CLUB
Organization’s Mailing Address 8703 PINE RIDGE BLVD
City DIAMONDHEAD
State MS
ZIP 39525
Accounting period End 12
Primary contact name HEATHER L CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEATHER CLARK
TREASURER
8703 PINE RIDGE BLVD
DIAMONDHEAD MS 39525

Officer/Director/Trustee Two

KELLY CHANG
PRESIDENT
911 8TH ST
BAY ST LOUIS MS 39520

Officer/Director/Trustee Three

CAROLINE SHAW
SECRETARY
11574 AZALEA TRACE
GULFPORT MS 39503

Officer/Director/Trustee Four

MICHELLE MULLINS
VICE PRESIDENT
204 N ISLAND VIEW AVE
LONG BEACH MS 39560

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2020
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HEATHER CLARK
Signature Title TREASURER
Signature Date 2/4/2020

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