FORM 1023-EZ for CANEY VALLEY BASKETBALL BOOSTER CLUB

Field Data
EIN 81-2663176
Case Number EO-2020038-000184
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CANEY VALLEY BASKETBALL BOOSTER CLUB
Organization’s Mailing Address 3434 SE KENTUCKY PLACE
City BARTLESVILLE
State OK
ZIP 74006
Accounting period End 12
Primary contact name KIMBERLY FOGLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY FOGLE
PRESIDENT
3434 KENTUCKY PL
BARTLESVILLE OK 74006

Officer/Director/Trustee Two

KATHY BARHAM
VICE PRESIDENT
1932 COUNTRY ROAD 2700
BARNSDALL OK 74002

Officer/Director/Trustee Three

BECKI GAILEY
SECRETARY
24241 N 3940 ROAD
OCHELATA OK 74051

Officer/Director/Trustee Four

DEBBIE BLACK
TREASURER
396811 W 2900 ROAD LOT 12
OCHELATA OK 74051

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2018
Organization Incorporation State OK
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: 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 KIMBERLY FOGLE
Signature Title PRESIDENT
Signature Date 2/5/2020

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