FORM 1023-EZ for BOLIVAR CHAPTER OF NATIONAL AMBUCS

Field Data
EIN 90-1115445
Case Number EO-2019066-000107
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BOLIVAR CHAPTER OF NATIONAL AMBUCS
Organization’s Mailing Address 4586 S 116TH RD
City BOLIVAR
State MO
ZIP 65613
Accounting period End 12
Primary contact name HOLLY SHULER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLLY SHULER
PRESIDENT
4586 S 116TH RD
BOLIVAR MO 65613

Officer/Director/Trustee Two

DEE BLAKEMORE
VICE PRESIDENT
4586 S 116TH RD
BOLIVAR MO 65613

Officer/Director/Trustee Three

ONETA SITTON
SECRETARY/TREASURER
4586 S 116TH RD
BOLIVAR MO 65613

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/15
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HOLLY SHULER
Signature Title PRESIDENT
Signature Date 3/4/19

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