FORM 1023-EZ for MARTIN LUTHER KING JR GIRLS SOCCERBOOSTER CLUB

Field Data
EIN 81-2835837
Case Number EO-2016243-000157
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARTIN LUTHER KING JR GIRLS SOCCERBOOSTER CLUB
Organization’s Mailing Address 9150 DAUCHY AVENUE
City RIVERSIDE
State CA
ZIP 92508-9325
Accounting period End 6
Primary contact name JENNITA TIBBETTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNITA TIBBETTS
DIRECTOR AND PRESIDENT
9150 DAUCHY AVENUE
RIVERSIDE CA 92508-9325

Officer/Director/Trustee Two

AMY DENNIS
DIRECTOR AND VICE PRESIDENT
17216 SEVEN SPRINGS WAY
RIVERSIDE CA 92504-9428

Officer/Director/Trustee Three

MICHELLE BERN
DIRECTOR AND SECRETARY
19166 SANVITALIA STREET
RIVERSIDE CA 92508-6634

Officer/Director/Trustee Four

LINDA ROBLES
DIRECTOR AND TREASURER
8536 NEW WINDSOR STREET
RIVERSIDE CA 92508-6167

Organization’s website NONE
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - 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 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 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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