FORM 1023-EZ for LADY WARRIOR HOOPS CLUB INC

Field Data
EIN 46-3918748
Case Number EO-2017187-000131
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LADY WARRIOR HOOPS CLUB INC
Organization’s Mailing Address 106 4TH STREET
City PIKEVILLE
State KY
ZIP 41501
Accounting period End 9
Primary contact name KEVIN PUCKETT CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BECKY POTTER
DIRECTOR
838 LICK CREEK ROAD
LICK CREEK KY 41540

Officer/Director/Trustee Two

RHONDA BLACKBURN
DIRECTOR
PO BOX 1117
ELKHORN CITY KY 41522

Officer/Director/Trustee Three

MISTY MURPHY
DIRECTOR
135 BIG HOLLOW DRIVE
MOUTHCARD KY 41548

Officer/Director/Trustee Four

LORIE MAY
DIRECTOR
ELKHORN CREEK RD
ELKHORN CITY KY 41522

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/2013
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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