FORM 1023-EZ for BLACK GOLD BOOSTER CLUB INC

Field Data
EIN 47-3626308
Case Number EO-2015295-000495
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK GOLD BOOSTER CLUB INC
Organization’s Mailing Address P O BOX 25
City GOODLAND
State KS
ZIP 67735
Accounting period End 12
Primary contact name J RONALD VIGNERY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JILL DEEDS
PRESIDENT DIRECTOR
1416 ARCADE
GOODLAND KS 67735

Officer/Director/Trustee Two

RANDY BELLAMY
VPRESIDENT DIRECTOR
1615 RD 51
GOODLAND KS 67735

Officer/Director/Trustee Three

COLLEEN DUELL
TREASURER DIRECTOR
7170 RD 10
GOODLAND KS 67735

Officer/Director/Trustee Four

MARY PORTERFIELD
SECRETARY DIRECTOR
2233 CALDWELL
GOODLAND KS 67735

Officer/Director/Trustee Five

GENNIFER GOLDEN
DIRECTOR
1010 W 10TH
GOODLAND KS 67735

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/2015
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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