FORM 1023-EZ for MONGOOSE BOXING CLUB INC

Field Data
EIN 82-2375183
Case Number EO-2017222-000595
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MONGOOSE BOXING CLUB INC
Organization’s Mailing Address 4617 S RACE ST
City MARION
State IN
ZIP 46952
Accounting period End 12
Primary contact name LINDA TAYLOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENNIS ROBERTS
PRESIDENT VICE PRESIDENT
4617 S RACE ST
MARION IN 46953

Officer/Director/Trustee Two

YOLANDA ROBERTS
SECRETARY TREASURER
4617 S RACE ST
MARION IN 46953

Officer/Director/Trustee Three

FULTON HOPKINS
DIRECTOR
317 EASTLAWN STREET
DETROIT MI 48215

Officer/Director/Trustee Four

NATE TAYLOR
DIRECTOR
1210 NICHOL AVENUE
ANDERSON IN 46016

Officer/Director/Trustee Five

JOE HUNTER
DIRECTOR
117 E MAIN
MUNCIE IN 47305

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/2012
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
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 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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