FORM 1023-EZ for DOMINION DIVE BOOSTERS CLUB INC

Field Data
EIN 46-1643804
Case Number EO-2018199-000154
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOMINION DIVE BOOSTERS CLUB INC
Organization’s Mailing Address 510-B MILL STREET NE
City VIENNA
State VA
ZIP 22180
Accounting period End 12
Primary contact name MICHELLE HECKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE SUTTON
DIRECTOR
11955 RAYBORN CREEK DRIVE
MANASSAS VA 20109

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/12
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STEPHANIE SUTTON
Signature Title DIRECTOR
Signature Date 7/16/18

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