FORM 1023-EZ for RIVERSIDE POLYTECHNIC GIRLS WATER POLO BOOSTER CLUB

Field Data
EIN 33-0896552
Case Number EO-2018155-000207
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RIVERSIDE POLYTECHNIC GIRLS WATER POLO BOOSTER CLUB
Organization’s Mailing Address 5450 VICTORIA AVENUE
City RIVERSIDE
State CA
ZIP 92506
Accounting period End 7
Primary contact name SHAILA CHAMBERLAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RONNI MCCARTY
PRESIDENT
6164 HAWARDEN DRIVE
RIVERSIDE CA 92506

Officer/Director/Trustee Two

SHAILA CHAMBERLAIN
VICE PRESIDENT
10651 ORCHARD VIEW LANE
RIVERSIDE CA 92503

Officer/Director/Trustee Three

DEBBIE TORMEY
SECRETARY
5423 BRITTANY AVENUE
RIVERSIDE CA 92506

Officer/Director/Trustee Four

KEITH BLOOM
TREASURER
2115 POSSUM COURT
SAN JACINTO CA 92582

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/17
Organization Incorporation State CA
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 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 SHAILA CHAMBERLAIN
Signature Title VICE PRESIDENT
Signature Date 5/31/18

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