FORM 1023-EZ for PALM HARBOR UNIVERSITY PERFORMINGARTS BOOSTER CLUB INC

Field Data
EIN 81-3471725
Case Number EO-2016237-000391
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PALM HARBOR UNIVERSITY PERFORMINGARTS BOOSTER CLUB INC
Organization’s Mailing Address 1900 OMAHA STREET
City PALM HARBOR
State FL
ZIP 34683
Accounting period End 6
Primary contact name CINDY KELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON GILBERG
PRESIDENT
2101 ALEXIS COURT
TARPON SPRINGS FL 34689

Officer/Director/Trustee Two

ROSEMARY COLLINS
VICE PRESIDENT OF CHORAL PROGRAM
3927 BLOOMINGHILL LANE
PALM HARBOR FL 34684

Officer/Director/Trustee Three

JENNIFER IACOVACCI
VICE PRESIDENT OF DRAMA PROGRAM
3101 TEAL TERRACE
SAFETY HARBOR FL 34695

Officer/Director/Trustee Four

CINDY KELLY
TREASURER
2664 CRYSTAL CIRCLE
DUNEDIN FL 34698

Officer/Director/Trustee Five

THAM LE
SECRETARY
2255 RICHTER STREET
DUNEDIN FL 34698

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/5/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 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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