FORM 1023-EZ for HAVILAH DANCE BOOSTER CLUB

Field Data
EIN 81-1020426
Case Number EO-2016117-000104
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAVILAH DANCE BOOSTER CLUB
Organization’s Mailing Address 10058 INDEPENDENCE BLVD
City MATTHEWS
State NC
ZIP 28105-4620
Accounting period End 12
Primary contact name TAMARA GASPAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAMARA GASPAR
PRESIDENT
829 CHASTAIN AVE
CONCORD NC 28025-7080

Officer/Director/Trustee Two

VALERIE ELLERBY
VICE PRESIDENT
10058 INDEPENDENCE BLVD
MATTHEWS NC 28105-4620

Officer/Director/Trustee Three

THERESA LIKINS
TREASURER
10058 INDEPENDENCE BLVD
MATTHEWS NC 28105-4620

Officer/Director/Trustee Four

GWENDOLYN HOLLEY
TREASURER
6408 SPRING GARDEN LN
CHARLOTTE NC 28213-5959

Officer/Director/Trustee Five

JODI WALKER
SECRETARY
10004 SILVERLING DR
WAXHAW NC 28173-7025

Organization’s website HTTP://TGASPAR94.WIX.COM/HDCBOOSTER
Organization’s email HDCBOOSTER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/2015
Organization Incorporation State NC
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: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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