FORM 1023-EZ for PECYLAK MEMORIAL BOYS BASKETBALL BOOSTER CLUB

Field Data
EIN 81-5077008
Case Number EO-2017026-000183
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PECYLAK MEMORIAL BOYS BASKETBALL BOOSTER CLUB
Organization’s Mailing Address 143 ROCKY REST ROAD
City SHELTON
State CT
ZIP 06484
Accounting period End 8
Primary contact name ROBERT ZURAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT ZURAW
PRESIDENT
143 ROCKY REST ROAD
SHELTON CT 06484

Officer/Director/Trustee Two

GEORGE GAMBLE
TREASURER
COLD SPRING CIRCLE
SHELTON CT 06484

Officer/Director/Trustee Three

BRIAN GARDINER
HEAD COACH
120 MEADOW STREET
SHELTON CT 06484

Organization’s website
Organization’s email ZURAWIC69@AOL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/2017
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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