FORM 1023-EZ for TEAM MOUNTAINEER

Field Data
EIN 46-4901851
Case Number EO-2015020-000307
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEAM MOUNTAINEER
Organization’s Mailing Address 1207 E VILLAGE DRIVE
City SOUTH CHARLESTON
State WV
ZIP 25309
Accounting period End 12
Primary contact name WILLIAM POORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TANEISHA POORE
TREASURER
1207 E VILLAGE DRIVE
SOUTH CHARLESTON WV 25309

Officer/Director/Trustee Two

WILLIAM POORE
PRESIDENT
1207 E VILLAGE DRIVE
SOUTH CHARLESTON WV 25309

Officer/Director/Trustee Three

JASON BAUSLEY
VICE PRESIDENT
907 PARK DRIVE
DUNBAR WV 25064

Officer/Director/Trustee Four

KIMBERLY BAUSLEY
TREASURER
907 PARK DRIVE
DUNBAR WV 25064

Officer/Director/Trustee Five

BRENDA WATKINS
SECRETARY
219 19TH STREET
DUNBAR WV 25064

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2014
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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
Signature Title
Signature Date

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