FORM 1023-EZ for ATKINS HIGH SCHOOL ARTS BOOSTER ORGANIZATION

Field Data
EIN 46-4145804
Case Number EO-2016155-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ATKINS HIGH SCHOOL ARTS BOOSTER ORGANIZATION
Organization’s Mailing Address 3605 OLD GREENSBORO ROAD
City WINSTON SALEM
State NC
ZIP 27101-2033
Accounting period End 6
Primary contact name LONDON CARPENTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEISHA HORTON
CO CHAIR
3605 OLD GREENSBORO ROAD
WINSTON SALEM NC 27101-2033

Officer/Director/Trustee Two

VICTORIA BAILEY
CO CHAIR
3605 OLD GREENSBORO ROAD
WINSTON SALEM NC 27101-2033

Officer/Director/Trustee Three

DAWN DUNCAN
TREASURER
3605 OLD GREENSBORO ROAD
WINSTON SALEM NC 27101-2033

Officer/Director/Trustee Four

LONDON CARPENTER
FUNDRAISER COORDINATOR
3605 OLD GREENSBORO ROAD
WINSTON SALEM NC 27101-2033

Organization’s website
Organization’s email AHSARTSBOOSTERCLUB@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2013
Organization Incorporation State NC
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
Signature Title
Signature Date

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