FORM 1023-EZ for PATRICK HENRY HIGH SCHOOL THEATRE BOOSTERS ORGANIZATION

Field Data
EIN 81-3895749
Case Number EO-2017072-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATRICK HENRY HIGH SCHOOL THEATRE BOOSTERS ORGANIZATION
Organization’s Mailing Address 12449 W PATRICK HENRY RD
City ASHLAND
State VA
ZIP 23005
Accounting period End 6
Primary contact name MARY SELBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA AGNEW
DIRECTOR
12449 W PATRICK HENRY RD
ASHLAND VA 23005

Officer/Director/Trustee Two

JANICE ALLEY
OFFICER-PRESIDENT
11277 OLD SCOTLAND RD
GLEN ALLEN VA 23059-1844

Officer/Director/Trustee Three

LUCIA GEMMELL
VICE PRESIDENT-OFFICER
11366 CARUTHERS WAY
GLEN ALLEN VA 23059-1844

Officer/Director/Trustee Four

MARY SELBY
TREASURER-OFFICER
11401 HALTONSHIRE WAY
GLEN ALLEN VA 23059-1844

Officer/Director/Trustee Five

PATRICIA STUART
SECRETARY-OFFICER
1782 JEFFERSON HIGHWAY
LOUISA VA 23093

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/20/2016
Organization Incorporation State VA
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: No
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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