FORM 1023-EZ for DAZZLER DANCE TEAM BOOSTER CLUB

Field Data
EIN 36-4875003
Case Number EO-2017243-000022
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DAZZLER DANCE TEAM BOOSTER CLUB
Organization’s Mailing Address 10612 SE 240TH STREET BOX 6241
City KENT
State WA
ZIP 98064-0055
Accounting period End 4
Primary contact name LORI STEPHENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORI STEPHENS
CO-PRESIDENT
12514 SE 259TH STREET
KENT WA 98030-8470

Officer/Director/Trustee Two

MELISSA HENRY
CO-PRESIDENT
10547 SE 233RD PLACE
KENT WA 98031-3349

Officer/Director/Trustee Three

ABIGAIL KALKA
TREASURER
25933 160TH AVE SE
COVINGTON WA 98042-8239

Officer/Director/Trustee Four

MICHELLE FERGUSON
SECRETARY
17004 SE 262ND STREET
COVINGTON WA 98042-8395

Organization’s website
Organization’s email DAZZLERBOOSTER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - 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 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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