FORM 1023-EZ for DOVER BASKETBALL BOOSTER CLUB

Field Data
EIN 81-4275589
Case Number EO-2016356-000167
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOVER BASKETBALL BOOSTER CLUB
Organization’s Mailing Address PO BOX 1091
City DOVER
State AR
ZIP 72837
Accounting period End 12
Primary contact name AMANDA BESTERFELDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICK MASSENGALE
PRESIDENT
41 BECKY BLVD
RUSSELLVILLE AR 72802

Officer/Director/Trustee Two

CHRIS BESTERFELDT
VICE-PRESIDENT
4530 BUCK MOUNTAIN ROAD
DOVER AR 72837

Officer/Director/Trustee Three

AMANDA BESTERFELDT
TREASURER
4530 BUCK MOUNTIN ROAD
DOVER AR 72837

Officer/Director/Trustee Four

KARLA BOWDEN
SECRETARY
47 VICK LANE
DOVER AR 72837

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2016
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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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