FORM 1023-EZ for LA VETA BOOSTER CLUB

Field Data
EIN 47-2747894
Case Number EO-2015029-000161
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LA VETA BOOSTER CLUB
Organization’s Mailing Address P O BOX 613
City LA VETA
State CO
ZIP 81055-0613
Accounting period End 12
Primary contact name TODD OBERHEU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LESLEE MILLER
PRESIDENT
5535 HWY 12
LA VETA CO 81055

Officer/Director/Trustee Two

JESSICA ANDREATTA
SECRETARY
1601 COUNTY RD 320
WALSENBURG CO 81089

Officer/Director/Trustee Three

MICHELLE ANDREATTA
VICE PRESIDENT
PO BOX 1290
LA VETA CO 81055-1290

Officer/Director/Trustee Four

LLUVIA MUSGRAVE
TREASURER
416 E GARLAND ST
LA VETA CO 81055

Officer/Director/Trustee Five

TODD OBERHEU
DIRECTOR
620 INDIANA AVE
WALSENBURG CO 81089

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2014
Organization Incorporation State CO
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: No
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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