FORM 1023-EZ for 65 SOS BOOSTER CLUB

Field Data
EIN 82-1948005
Case Number EO-2017177-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 65 SOS BOOSTER CLUB
Organization’s Mailing Address 304 TERRY AVE
City HURLBURT FIELD
State FL
ZIP 32544
Accounting period End 10
Primary contact name KEVIN PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN PETERSON
PRESIDENT
229 TECUMSEH LANE
MARY ESTHER FL 32569

Officer/Director/Trustee Two

JUSTIN TRIMBLE
VICE PRESIDENT
1996 SUNDOWN CT
NAVARRE FL 32566

Officer/Director/Trustee Three

DAVID LEE
TREASURER
9 LEWIS DR
HURLBURT FIELD FL 32544

Officer/Director/Trustee Four

JON MANGELS
SECRETARY
301 TULLY ST
HURLBURT FIELD FL 32544

Organization’s website
Organization’s email REMOTELYHURBY@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J11 - 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
Signature Title
Signature Date

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