FORM 1023-EZ for NER-IV ATHLETIC BOOSTER CLUB

Field Data
EIN 84-2574003
Case Number EO-2019217-000248
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NER-IV ATHLETIC BOOSTER CLUB
Organization’s Mailing Address 301 W MARTIN
City CAIRO
State MO
ZIP 65239
Accounting period End 12
Primary contact name SUSAN ELLISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN ELLISON
PRESIDENT
2577 COUNTY ROAD 1265
HUNTSVILLE MO 65259

Officer/Director/Trustee Two

RACHEL HARMAN
VICE-PRESIDENT
2523 HIGHWAY K
CAIRO MO 65239

Officer/Director/Trustee Three

SARA PREWETT
TREASURER
1987 COUNTY ROAD 1620
CAIRO MO 65239

Officer/Director/Trustee Four

CATHY TAYLOR
SECRETARY
8567 HIGHWAY J
JACKSONVILLE MO 65260

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/19
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T11 - 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 SUSAN ELLISON
Signature Title PRESIDENT
Signature Date 8/1/19

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