FORM 1023-EZ for COMMUNITY R-VI ATHLETIC BOOSTER CLUB

Field Data
EIN 83-1281302
Case Number EO-2018204-000266
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY R-VI ATHLETIC BOOSTER CLUB
Organization’s Mailing Address 35063 HIGHWAY BB
City LADDONIA
State MO
ZIP 63352
Accounting period End 12
Primary contact name PHILIP J YORK ATTORNEY AT LAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALISHA GLASGOW
PRESIDENT
3271 HIGHWAY 19
LADDONIA MO 63352

Officer/Director/Trustee Two

CINDY FORT
VICE PRESIDENT
16870 HIGHWAY A
MARTINSBURG MO 65264

Officer/Director/Trustee Three

AMBER FORBIS
TREASURER
709 SOUTH CLARK STREET
MEXICO MO 65265

Officer/Director/Trustee Four

PAULA STAFFORD
SECRETARY
38518 HIGHWAY K
LADDONIA MO 63352

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/18
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 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 ALISHA GLASGOW
Signature Title PRESIDENT
Signature Date 7/19/18

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