FORM 1023-EZ for THE SHELTON NJROTC BOOSTER CLUB

Field Data
EIN 91-1451383
Case Number EO-2016159-000182
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE SHELTON NJROTC BOOSTER CLUB
Organization’s Mailing Address PO BOX 82
City SHELTON
State WA
ZIP 98584
Accounting period End 6
Primary contact name KRISTINA NEWBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HARMON POWERS
PRESIDENT
625 W RAILROAD
SHELTON WA 98584

Officer/Director/Trustee Two

IRENE WIRSTROM
VICE PRESIDENT
321 SE ALPINE AVE
SHELTON WA 98584

Officer/Director/Trustee Three

KAREN JENSON
SECRETARY
1052 E SOUTH ISLAND DR
SHELTON WA 98584

Officer/Director/Trustee Four

KRISTINA NEWBY
TREASURER
3431 SE LYNCH RD
SHELTON WA 98584

Officer/Director/Trustee Five

CHRISTINA PETERSEN
PUBLIC AFFAIRS OFFICER
428 W I STREET
SHELTON WA 98584

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/1999
Organization Incorporation State WA
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: 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 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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