FORM 1023-EZ for CAPTIVATION BOOSTER CLUB

Field Data
EIN 82-3371975
Case Number EO-2018033-000200
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAPTIVATION BOOSTER CLUB
Organization’s Mailing Address 1550 WEST HORIZON RIDGE SUITE 34
City HENDERSON
State NV
ZIP 89012
Accounting period End 7
Primary contact name EILEEN BEVACQUA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EILEEN BEVACQUA
PRESIDENT
499 CAPE ALAN DRIVE
HENDERSON NV 89052

Officer/Director/Trustee Two

PAOLA ALMARAZ
SECRETARY
897 SIR RALEIGH COURT
HENDERSON NV 89052

Officer/Director/Trustee Three

KERRY-FRANCES BOURNE
TREASURER
178 SPRINGFIELD ST
HENDERSON NV 89074

Organization’s website
Organization’s email CAPTIVATIONBOOSTERCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/17
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A62 - Dance
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 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name EILEEN BEVACQUA
Signature Title PRESIDENT
Signature Date 1/31/18

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