FORM 1023-EZ for BARRINGTON HIGH SCHOOL GIRLS TRACKXC BOOSTER CLUB

Field Data
EIN 84-1653686
Case Number EO-2015078-000392
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BARRINGTON HIGH SCHOOL GIRLS TRACKXC BOOSTER CLUB
Organization’s Mailing Address 8 POLO DRIVE
City SOUTH BARRINGTON
State IL
ZIP 60010
Accounting period End 12
Primary contact name JEFF BERGREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN BERGREN
PRESIDENT
8 POLO DRIVE
SOUTH BARRINGTON IL 60010

Officer/Director/Trustee Two

AMY NYKAZA
SECRETARY
764 CONCORD LANE
BARRINGTON IL 60010

Officer/Director/Trustee Three

JEFF BERGREN
TREASURER
8 POLO DRIVE
SOUTH BARRINGTON IL 60010

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2004
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - 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 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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