FORM 1023-EZ for BELLEVUE ACADEMIC BOOSTER ASSOCIATION

Field Data
EIN 81-4315090
Case Number EO-2016348-000331
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELLEVUE ACADEMIC BOOSTER ASSOCIATION
Organization’s Mailing Address 250 W MAIN ST
City BELLEVUE
State OH
ZIP 44811
Accounting period End 12
Primary contact name TANHAN HICKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELINE BECKS
PRESIDENT
6280 TWP RD 82
BELLEVUE OH 44811

Officer/Director/Trustee Two

MICHAEL BECKS
TREASURER
6280 TWP RD 82
BELLEVUE OH 44811

Officer/Director/Trustee Three

TANHAN HICKS
VICE PRESIDENT
1000 MONROE ST
BELLEVUE OH 44811

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 Yes
One Third Support Gifts No
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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