FORM 1023-EZ for CLOVER HILL EXPONENTS

Field Data
EIN 47-4921425
Case Number EO-2015245-000338
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLOVER HILL EXPONENTS
Organization’s Mailing Address 13301 KELLY GREEN LANE
City MIDLOTHIAN
State VA
ZIP 23112
Accounting period End 6
Primary contact name ELIZABETH TRIESLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JENNIFER HIGGINS
PRESIDENT
3206 CROSSINGS WAY
MIDLOTHIAN VA 23113

Officer/Director/Trustee Two

BROOKE MANCINI
VICE PRESIDENT
15807 ROBYNSMERE WAY
MOSELY VA 23120

Officer/Director/Trustee Three

KATHY FOX
SECRETARY
9604 GATES BLUFF DRIVE
CHESTERFIELD VA 23832

Officer/Director/Trustee Four

ELIZABETH TRIESLER
TREASURER
11830 RIVERPARK TERRACE
CHESTERFIELD VA 23838

Organization’s website HTTPS://SITES.GOOGLE.COM/SITE/CHHSEXPONENTS/
Organization’s email CHHSEXPONENTSSUG@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: No
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 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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