FORM 1023-EZ for BLUE DRAGON BOOSTERS

Field Data
EIN 82-1446197
Case Number EO-2017173-000367
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE DRAGON BOOSTERS
Organization’s Mailing Address 610 NORTHFIELD CIRCLE
City GARRETSON
State SD
ZIP 57030
Accounting period End 12
Primary contact name JOEY ROTERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAY SWATECK
DIRECTOR
808 E LESLIE DRIVE
GARRETSON SD 57030

Officer/Director/Trustee Two

JASON BLOSMO
DIRECTOR
320 N MAIN AVENUE
GARRETSON SD 57030

Officer/Director/Trustee Three

JAIME BENSON
DIRECTOR
48053 250TH STREET
GARRETSON SD 57030

Officer/Director/Trustee Four

SHAWN FREWALDT
DIRECTOR
25559 485TH AVENUE
GARRETSON SD 57030

Officer/Director/Trustee Five

JOEY ROTERT
DIRECTOR
816 JACOB CIRCLE
GARRETSON SD 57030

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2017
Organization Incorporation State SD
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: Yes
Educational: Yes
Scientific: Yes
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
Signature Title
Signature Date

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