FORM 1023-EZ for HALIFAX COUNTY ATHLETIC BOOSTER CLUB

Field Data
EIN 80-0954444
Case Number EO-2015089-000285
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HALIFAX COUNTY ATHLETIC BOOSTER CLUB
Organization’s Mailing Address P O BOX 311
City SOUTH BOSTON
State VA
ZIP 24592
Accounting period End 12
Primary contact name JASON H CAMP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GLENN RATLIFF
INTERIM PRESIDENT
1 HIGH SCHOOL CIRCLE
SOUTH BOSTON VA 24592

Officer/Director/Trustee Two

ANGIE SCOTT
VICE-PRESIDENT MEMBERSHIP
1 HIGH SCHOOL CIRCLE
SOUTH BOSTON VA 24592

Officer/Director/Trustee Three

JULIANNA BERRY
VICE-PRESIDENT COMMUNICATION
1 HIGH SCHOOL CIRCLE
SOUTH BOSTON VA 24592

Officer/Director/Trustee Four

SUSAN MCLAMB
TREASURER
1 HIGH SCHOOL CIRCLE
SOUTH BOSTON VA 24592

Officer/Director/Trustee Five

JASON CAMP
SECRETARY
1 HIGH SCHOOL CIRCLE
SOUTH BOSTON VA 24592

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/2015
Organization Incorporation State VA
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: 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 Yes
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 Yes
One Third Support Gifts No
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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