FORM 1023-EZ for TRI-VALLEY BEARS PTO

Field Data
EIN 84-2459799
Case Number EO-2019302-000247
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRI-VALLEY BEARS PTO
Organization’s Mailing Address PO BOX 43
City GRAHAMSVILLE
State NY
ZIP 12740
Accounting period End 12
Primary contact name ERIK RAYKOFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE BURKEY
PRESIDENT
580 ROUTE 55A
NAPANOCH NY 12458

Officer/Director/Trustee Two

NICOLE SQUIRES
VICE-PRESIDENT
617 BENTON HOLLOW ROAD
WOODBOURNE NY 12788

Officer/Director/Trustee Three

MELISSA WILHELM
SECRETARY
248 PEPACTON HOLLOW ROAD
GRAHAMSVILLE NY 12740

Officer/Director/Trustee Four

ERIK RAYKOFF
TREASURER
636 BIG HOLLOW ROAD
GRAHAMSIVLLE NY 12740

Organization’s website HTTPS://WWW.FACEBOOK.COM/TV-BEARS-PTO-848826388799110/
Organization’s email TRIVALLEYSCHOOLPTO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/19
Organization Incorporation State NY
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: No
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 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 ERIK RAYKOFF
Signature Title TREASURER
Signature Date 10/27/19

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