FORM 1023-EZ for PINE ISLAND FOOTBALL BOOSTER CLUB

Field Data
EIN 82-3607221
Case Number EO-2018075-000282
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PINE ISLAND FOOTBALL BOOSTER CLUB
Organization’s Mailing Address 223 1ST AVE SE
City PINE ISLAND
State MN
ZIP 55963
Accounting period End 12
Primary contact name SAMANTHA MCDONOUGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMANTHA MCDONOUGH
PRESIDENT
1090 RIVERWOOD DRIVE SW
ORONOCO MN 55960

Officer/Director/Trustee Two

CARRIE OREILLY
VICE PRESIDEN
1180 ALONA LN SW
ORONOCO MN 55960

Officer/Director/Trustee Three

HEATHER WEBER
TREASURER
121 1ST AVE NW
PINE ISLAND MN 55963

Officer/Director/Trustee Four

MELINDA DIVELY-WHITE
SECRETARY
430 EAGLE VIEW LN SE
ORONOCO MN 55960

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/17/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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 Yes
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 SAMANTHA MCDONOUGH
Signature Title PRESIDENT
Signature Date 3/14/18

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