FORM 1023-EZ for MOUNDS VIEW HIGH SCHOOL VOLLEYBALLBOOSTER CLUB

Field Data
EIN 41-1855289
Case Number EO-2015117-000457
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNDS VIEW HIGH SCHOOL VOLLEYBALLBOOSTER CLUB
Organization’s Mailing Address 1245 JOSEPHINE RD
City ROSEVILLE
State MN
ZIP 55113
Accounting period End 12
Primary contact name JENNIFER URBAN - CAF NO 0308-14263R
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAM NEWCOME
PRESIDENT
1245 JOSEPHINE RD
ROSEVILLE MN 55113

Officer/Director/Trustee Two

DENISE FULLERTON
TREASURER
1348 EIDE CIRCLE
ARDEN HILLS MN 55112

Officer/Director/Trustee Three

JULIA MELK
FUNDRAISING CHAIR
8137 STOWE AVE
ARDEN HILLS MN 55112

Officer/Director/Trustee Four

TAMMY THOMPSON
EVENT CHAIR
1365 BURKE AVE W
ROSEVILLE MN 55113

Officer/Director/Trustee Five

JEFF CERKVENIK
MARKETING CHAIR
1051 BUCHER AVE
SHOREVIEW MN 55126

Organization’s website HTTP://WWW.MOUNDSVIEWVOLLEYBALL.COM/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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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