FORM 1023-EZ for OLATHE NORTH SPORTS MEDICINE BOOSTER CLUB

Field Data
EIN 81-4376698
Case Number EO-2019303-000312
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OLATHE NORTH SPORTS MEDICINE BOOSTER CLUB
Organization’s Mailing Address 600 E PRAIRIE ST
City OLATHE
State KS
ZIP 66061
Accounting period End 6
Primary contact name KELLY KLUSMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLI BEURMAN
PRESIDENT
14400 W 123RD TERR
OLATHE KS 66062

Officer/Director/Trustee Two

MICHELLE LAWSON
VICE PRESIDENT
312 S STONECREST
OLATHE KS 66061

Officer/Director/Trustee Three

TONIA BLUE
TREASURER
11700 W 115TH ST
OVERLAND PARK KS 66210

Organization’s website
Organization’s email SPORTSMEDBOOSTER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/11/16
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 TONIA BLUE
Signature Title TREASURER
Signature Date 10/28/19

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