FORM 1023-EZ for PLATEAU VALLEY ATHLETIC BOOSTER CLUB

Field Data
EIN 82-2446884
Case Number EO-2018128-000911
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PLATEAU VALLEY ATHLETIC BOOSTER CLUB
Organization’s Mailing Address PO BOX 87
City MOLINA
State CO
ZIP 61626
Accounting period End 8
Primary contact name JOLYNN DORMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WENDY NICHOLS
PRESIDENT
PO BOX 87
MOLINA CO 81646

Officer/Director/Trustee Two

JOLYNN DORMAN
VICE PRESIDENT
PO BOX 22
COLLBRAN CO 81624

Officer/Director/Trustee Three

HEATHER JENKINS
TREASURER
16933 KIMBAL CREEK ROAD
COLLBRAN CO 81624

Officer/Director/Trustee Four

JENNIFER CRITES
DIRECTOR
14599 52 1/2 ROAD
COLLBRAN CO 81624

Officer/Director/Trustee Five

ERIN CLARK
SERATARY
54043 HIGHWAY 330
COLLBRAN CO 81624

Organization’s website N/A
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/17
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 JOLYNN DORMAN
Signature Title VICE PRESIDENT
Signature Date 5/3/18

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