FORM 1023-EZ for INDEPENDENCE ATHLETIC BOOSTER CLUB

Field Data
EIN 46-3877376
Case Number EO-2014343-000078
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INDEPENDENCE ATHLETIC BOOSTER CLUB
Organization’s Mailing Address 23786 INDEE BLVD
City INDEPENDENCE
State WI
ZIP 54747
Accounting period End 6
Primary contact name BARRY SCHMITT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LYNETTE SPELTZ
PRESIDENT
N36794 GIEROK RD
INDEPENDENCE WI 54747

Officer/Director/Trustee Two

TRACY HALAMA
VICE-PRESIDENT
23557 INDEE BLVD
INDEPENDENCE WI 54747

Officer/Director/Trustee Three

JAMI KABUS
SECRETARY
35244 DIAGONAL RD
INDEPENDENCE WI 54747

Officer/Director/Trustee Four

RICHARD WARNER
TREASURER
35465 7TH STREET
INDEPENDENCE WI 54747

Officer/Director/Trustee Five

BARRY SCHMITT
ATHLETIC DIRECTOR
35881 CHESTNUT ST
INDEPENDENCE WI 54747

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/2013
Organization Incorporation State WI
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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