FORM 1023-EZ for ROOSEVELT UNITED BOOSTER CLUB

Field Data
EIN 82-2654746
Case Number EO-2019092-000414
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROOSEVELT UNITED BOOSTER CLUB
Organization’s Mailing Address 5644 12TH AVE S
City MINNEAPOLIS
State MN
ZIP 55417
Accounting period End 12
Primary contact name BETH REISKYTL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHLEEN DONOHOE
PRESIDENT, DIRECTOR
3921 10TH AVE
MINNEAPOLIS MN 55407

Officer/Director/Trustee Two

SILVIA ZAVALETA-IHME
TREASURER, DIRECTOR
5644 12TH AVE S
MINNEAPOLIS MN 55417

Officer/Director/Trustee Three

MARYKAYE CHAMPA
SECRETARY, DIRECTOR
10001 MORRIS RD
BLOOMINGTON MN 55437

Officer/Director/Trustee Four

ELIZABETH LARSON
DIRECTOR
327 E 43RD ST
MINNEAPOLIS MN 55409

Officer/Director/Trustee Five

JAKE THOMPSON
DIRECTOR
3815 26TH AVE S
MINNEAPOLIS MN 55406

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/17
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 SILVIA ZAVALETA-IHME
Signature Title TREASURER, DIRECTOR
Signature Date 3/30/19

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