FORM 1023-EZ for DHS MENS BASKETBALL BOOSTER CLUB INC

Field Data
EIN 84-1990048
Case Number EO-2019273-000207
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DHS MENS BASKETBALL BOOSTER CLUB INC
Organization’s Mailing Address 10055 SW 180TH AVENUE RD
City DUNNELLON
State FL
ZIP 34432
Accounting period End 12
Primary contact name DANIELLE CASEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIELLE CASEY
PRESIDENT
10055 SW 180TH AVENUE RD
DUNNELLON FL 34432

Officer/Director/Trustee Two

GREG SPATES
VICE PRESIDENT
10055 SW 180TH AVENUE RD
DUNNELLON FL 34432

Officer/Director/Trustee Three

NELSON RODRIGUEZ
SECRETARY
10055 SW 180TH AVENUE RD
DUNNELLON FL 34432

Organization’s website
Organization’s email DHSMENSBASKETBALLBOOSTER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/21/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
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 DANIELLE CASEY
Signature Title PRESIDENT
Signature Date 9/26/19

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