FORM 1023-EZ for VERRADO SWIM & DIVE BOOSTER CLUB

Field Data
EIN 84-2331119
Case Number EO-2019247-000223
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VERRADO SWIM & DIVE BOOSTER CLUB
Organization’s Mailing Address 20050 W INDIAN SCHOOL RD
City BUCKEYE
State AZ
ZIP 85396
Accounting period End 12
Primary contact name JAIME LUDKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDI MOSTOFO
PRESIDENT
20050 W INDIAN SCHOOL RD
BUCKEYE AZ 85396

Officer/Director/Trustee Two

KRISTEN ANGELOVIC
VICE PRESIDENT
20050 W INDIAN SCHOOL RD
BUCKEYE AZ 85396

Officer/Director/Trustee Three

KRISTEN TIFFANY
SECRETARY
20050 W INDIAN SCHOOL RD
BUCKEYE AZ 85396

Officer/Director/Trustee Four

JAIME LUDKA
TREASURER
20050 W INDIAN SCHOOL RD
BUCKEYE AZ 85396

Officer/Director/Trustee Five

SARAH BYERS
STATUTORY AGENT
20050 W INDIAN SCHOOL RD
BUCKEYE AZ 85396

Organization’s website N/A
Organization’s email VIPERSWIMDIVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/19
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 JAIME LUDKA
Signature Title TREASURER
Signature Date 9/2/19

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