FORM 1023-EZ for JEFFERSON BOOSTERS

Field Data
EIN 85-3558030
Case Number EO-2021085-000310
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFFERSON BOOSTERS
Organization’s Mailing Address 5707 WILLIAMS ROAD
City NEWPORT
State MI
ZIP 48166
Accounting period End 6
Primary contact name MICHELLE HEMWALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MISTY ETHERIDGE ETHERIDGE
PRESIDENT
124 ABERDEEN LANE
MONROE MI 48161

Officer/Director/Trustee Two

HEIDI NOLAN
VICE PRESIDENT
2418 NORTH DIXIE HWY
MONROE MI 48162

Officer/Director/Trustee Three

DANNIELLE PEER
TREASURER
4357 1ST STREET
NEWPORT MI 48166

Officer/Director/Trustee Four

JULIE BRDA
SECRETARY
7566 AUDUBON LANE
NEWPORT MI 48166

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2020
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - 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 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 MISTY ETHERIDGE ETHERIDGE
Signature Title PRESIDENT
Signature Date 2/2/2021

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