FORM 1023-EZ for SCOTTIES GIRLS LACROSSE BOOSTER INC

Field Data
EIN 47-3013809
Case Number EO-2015075-000495
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SCOTTIES GIRLS LACROSSE BOOSTER INC
Organization’s Mailing Address 329 JATSKI DRIVE
City BALLSTON SPA
State NY
ZIP 12020
Accounting period End 12
Primary contact name JENNIFER BLAAUBOER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JENNIFER BLAAUBOER
MEMBER
329 JATSKI DRIVE
BALLSTON SPA NY 12020

Officer/Director/Trustee Two

PAUL BLAZEJESKI
PRESIDENT
23 KOZYLANE
MALTA NY 12020

Officer/Director/Trustee Three

JOHN DEVITO
VICE PRESIDENT
36 CENTURY DRIVE
BALLSTON SPA NY 12020

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2015
Organization Incorporation State NY
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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