FORM 1023-EZ for ROBOTICS OF CENTRAL KITSAP BOOSTERCLUB

Field	Data
EIN	83-3597248
Case Number	EO-2019281-000344
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	ROBOTICS OF CENTRAL KITSAP BOOSTERCLUB
Organization’s Mailing Address	8121 BERRY RIDGE LN NW
City	SILVERDALE
State	WA
ZIP	98383
Accounting period End	2
Primary contact name	DENISE M JUDD
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00

Officer/Director/Trustee One

DENISE JUDD
PRESIDENT
8121 BERRY RIDGE LN NW
SILVERDALE WA 98383

Officer/Director/Trustee Two

LAURA MORTIMORE
VICE-PRESIDENT
6843 TRISTEN LN NW
BREMERTON WA 98312

Officer/Director/Trustee Three

SPRING GIDEON
TREASURER
3417 NW DONIDA DR
BREMERTON WA 98310

Officer/Director/Trustee Four

HEATHER LINFORD
SECRETARY
4007 NE LUXURY LN
BREMERTON WA 98311

Organization’s website	WWW.ROCKBOOSTERS.COM
Organization’s email	ROCK.BOOSTERCLUB@GMAIL.COM
Organization Incorporated	Yes
Organization trust	No
Necessary Organizing Documents	Yes
Organization Incorporation Date	2/9/19
Organization Incorporation State	WA
Contains Limitation	Yes
Does not expressly empower	Yes
Contains dissolution	Yes
National Taxonomy of Exempt Entities (NTEE) code	U12 - Fund Raising and/or Fund Distribution
Organization’s purpose	Charitable: No 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	No
One Third Support Gifts	Yes
Benefit of College	No
Private Foundation 508(e)	No
Seeking Retroactive Reinstatement	No
Seeking Section 7 Reinstatement	No
Correctness Declaration	Yes
Signature Name	DENISE JUDD
Signature Title	PRESIDENT
Signature Date	10/6/19
EIN	83-3597248
Case Number	EO-2019281-000344
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	ROBOTICS OF CENTRAL KITSAP BOOSTER CLUB
Organization’s Mailing Address	8121 BERRY RIDGE LN NW
City	SILVERDALE
State	WA
ZIP	98383
Accounting period End	2
Primary contact name	DENISE M JUDD
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00