FORM 1023-EZ for GLACIER PEAK BOYS BASKETBALL BOOSTER CLUB

Field Data
EIN 26-2519800
Case Number EO-2016288-000170
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GLACIER PEAK BOYS BASKETBALL BOOSTER CLUB
Organization’s Mailing Address 13300 BOTHELL EVERETT HWY 303-609
City MILL CREEK
State WA
ZIP 98012
Accounting period End 4
Primary contact name REED PURCELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE PURCELL
CO-PRESIDENT
4806 118TH PLACE SE
EVERETT WA 98208

Officer/Director/Trustee Two

LIZ FORMAN
CO-PRESIDENT
18615 BROADWAY AVE
SNOHOMISH WA 98296

Officer/Director/Trustee Three

REED PURCELL
TREASURER
4806 118TH PLACE SE
EVERETT WA 98208

Officer/Director/Trustee Four

BEAN RODIN
VICE PRESIDENT
13620 LOST LAKE RD
SNOHOMISH WA 98296

Officer/Director/Trustee Five

ANDREW DOUGLAS
VICE PRESIDENT
15526 63RD DRIVE SE
SNOHOMISH WA 98296

Organization’s website WWW.GLACIERPEAKBOYSBASKETBALL.COM
Organization’s email GPBBBBC@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2008
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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