FORM 1023-EZ for SUMMERSVILLE GRADE SCHOOL BOOSTER CLUB

Field Data
EIN 20-1090115
Case Number EO-2019280-000499
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUMMERSVILLE GRADE SCHOOL BOOSTER CLUB
Organization’s Mailing Address 1118 FAIRFIELD ROAD
City MOUNT VERNON
State IL
ZIP 62864-5726
Accounting period End 6
Primary contact name NATHAN MAST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHAN MAST
PRESIDENT
836 MCCAULEY ROAD
MOUNT VERNON IL 62864-5766

Officer/Director/Trustee Two

CINDY TINSLEY
VICE PRESIDENT
14175 N MEMORY LANE
MOUNT VERNON IL 62864-8510

Officer/Director/Trustee Three

ANDREA SHUPE
SECRETARY
12 HUNTERS RIDGE
MOUNT VERNON IL 62864-5773

Organization’s website SUMMERSVILLE79.COM
Organization’s email SGS79BOOSTER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/84
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 NATHAN MAST
Signature Title PRESIDENT
Signature Date 10/5/19

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