FORM 1023-EZ for HILLGROVE CROSS COUNTRY BOOSTER CLUB INC

Field Data
EIN 47-2885511
Case Number EO-2015044-000072
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HILLGROVE CROSS COUNTRY BOOSTER CLUB INC
Organization’s Mailing Address 4165 LUTHER WARD ROAD
City POWDER SPRINGS
State GA
ZIP 30127
Accounting period End 12
Primary contact name JONATHAN GAMBRELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AMY BRAND
PRESIDENT
5700 HATCHERY WAY
POWDER SPRINGS GA 30127

Officer/Director/Trustee Two

CLAIRE STARKS
SECRETARY/TREASURER
1259 GATE POST LANE
POWDER SPRINGS GA 30127

Officer/Director/Trustee Three

JONATHAN GAMBRELL
DIRECTOR
184 CEDARCREST DRIVE
ACWORTH GA 30101

Officer/Director/Trustee Four

TRACI BENSLEY
DIRECTOR
5658 WESTHORPE LANE
POWDER SPRINGS GA 30127

Officer/Director/Trustee Five

JOHN FRANKLIN
DIRECTOR
3197 GAINER DRIVE
POWDER SPRINGS GA 30127

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/2/2015
Organization Incorporation State GA
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: 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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