FORM 1023-EZ for LADY VIKES LACROSSE BOOSTER CLUB INC

Field Data
EIN 83-2330851
Case Number EO-2018340-000593
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LADY VIKES LACROSSE BOOSTER CLUB INC
Organization’s Mailing Address PO BOX 515
City MIDDLETON
State ID
ZIP 83644-515
Accounting period End 12
Primary contact name JASON SPICKELMIRE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELODY SMEDICK
PRESIDENT / DIRECTOR
PO BOX 515
MIDDLETON ID 83644-515

Officer/Director/Trustee Two

RAQUEL KOEHLER
VICE PRESIDENT / DIRECTOR
PO BOX 515
MIDDLETON ID 83644-515

Officer/Director/Trustee Three

ANGELA CHAMPION
SECRETARY / DIRECTOR
PO BOX 515
MIDDLETON ID 83644-515

Officer/Director/Trustee Four

JASON SPICKELMIRE
TREASURER / DIRECTOR
PO BOX 515
MIDDLETON ID 83644-515

Officer/Director/Trustee Five

VICKI LEWIS
PARENT REP / DIRECTOR
PO BOC 515
MIDDLETON ID 83644-515

Organization’s website N/A
Organization’s email LADYVIKESLAX@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/18
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 JASON SPICKELMIRE
Signature Title TREASURER / DIRECTOR
Signature Date 12/4/18

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