FORM 1023-EZ for BURLINGTON-EDISON HIGH SCHOOL GIRLSSOCCER BOOSTER CLUB

Field Data
EIN 46-3677862
Case Number EO-2014240-000543
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BURLINGTON-EDISON HIGH SCHOOL GIRLSSOCCER BOOSTER CLUB
Organization’s Mailing Address 20567 ECHO HILL ROAD
City SEDRO WOOLLEY
State WA
ZIP 98284
Accounting period End 8
Primary contact name JOHN BURKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LITA DEBOER
DIRECTOR/PRESIDENT
20567 ECHO HILL ROAD
SEDRO WOOLLEY WA 98284

Officer/Director/Trustee Two

CARRIE HAYTON
DIRECTOR/SECRETARY
7410 TEAL LANE
BOW WA 98232

Officer/Director/Trustee Three

SHYRA WHITE
DIRECTOR
531 GREENLEAF AVE APARTMENT B
BURLINGTON WA 98233

Officer/Director/Trustee Four

JENNIFER HARLAN
DIRECTOR
19630 LANDING ROAD
MOUNT VERNON WA 98273

Officer/Director/Trustee Five

BEVERLY DIMOCK
DIRECTOR
810 PETERSON ROAD
BURLINGTON WA 98233

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/9/2013
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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