FORM 1023-EZ for LONG BEACH POLY GIRLS WATER POLO BOOSTER CLUB

Field Data
EIN 83-2707436
Case Number EO-2019108-000164
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LONG BEACH POLY GIRLS WATER POLO BOOSTER CLUB
Organization’s Mailing Address PO BOX 14728
City LONG BEACH
State CA
ZIP 90803-9993
Accounting period End 7
Primary contact name JOHN BOOTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN BOOTH
CO-PRESIDENT
2333 MYRTLE AVE
LONG BEACH CA 90806

Officer/Director/Trustee Two

TERESA BRIAN
CO-PRESIDENT
2333 MYRTLE AVE
LONG BEACH CA 90806

Officer/Director/Trustee Three

KARIN KIM
VICE PRESIDENT
3556 N WESTON PLACE
LONG BEACH CA 90807

Officer/Director/Trustee Four

TIM SNYDER
TREASURER
31 BELMONT AVENUE
LONG BEACH CA 90806

Officer/Director/Trustee Five

BRENDA JUAREZ
SECRETARY
7143 E KEYNOTE STREET
LONG BEACH CA 90806

Organization’s website POLYGIRLSWATERPOLO.COM
Organization’s email LBPOLYGIRLSPOLO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/99
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 JOHN BOOTH
Signature Title CO-PRESIDENT
Signature Date 4/16/19

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