FORM 1023-EZ for CENTENNIAL THEATRE BOOSTERS

Field Data
EIN 84-4061416
Case Number EO-2020035-000308
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CENTENNIAL THEATRE BOOSTERS
Organization’s Mailing Address 7122 MOURNING DOVE RD
City LINO LAKES
State MN
ZIP 55014-3202
Accounting period End 6
Primary contact name KIM HERNDON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER LAVANDOWSKA
PRESIDENT
8643 BRANT ST NE
BLAINE MN 55014-4038

Officer/Director/Trustee Two

MONICA GORTON
VICE-PRESIDENT
4900 106TH AVE NE
CIRCLE PINES MN 55014-1561

Officer/Director/Trustee Three

MELISSA KRIEGER
SECRETARY
638 PRAIRIE FLOWER RD
LINO LAKES MN 55014-1957

Officer/Director/Trustee Four

KIMBERLEE HERNDON
TREASURER
7122 MOURNING DOVE RD
LINO LAKES MN 55014-3202

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/9/2019
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A11 - 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 KIMBERLEE HERNDON
Signature Title TREASURER
Signature Date 2/2/2020

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