FORM 1023-EZ for LAVILLE ATHLETIC BOOSTER CLUB INC

Field Data
EIN 31-1131095
Case Number EO-2021085-000334
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAVILLE ATHLETIC BOOSTER CLUB INC
Organization’s Mailing Address PO BOX 456
City LAKEVILLE
State IN
ZIP 46536-0456
Accounting period End 12
Primary contact name LISA HOMINIUK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGIE MEDORS
PRESIDENT
1550 BYRON DR
SOUTH BEND IN 46614-2856

Officer/Director/Trustee Two

BETH GOOD
VICE PRESIDENT
1850 LINDEN RD
PLYMOUTH IN 46563-9554

Officer/Director/Trustee Three

LORILYN DILL
TREASURER
13044 W 1ST RD
LAKEVILLE IN 46536-9607

Officer/Director/Trustee Four

LISA HOMINIUK
SECRETARY
23218 OSBORNE RD
SOUTH BEND IN 46614-9482

Organization’s website N/A
Organization’s email LAVILLELBC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/26/1984
Organization Incorporation State IN
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: 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 Yes
Correctness Declaration Yes
Signature Name LISA HOMINIUK
Signature Title SECRETARY
Signature Date 2/3/2021

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