FORM 1023-EZ for PRIME TIGER TAEKWONDO BOOSTER CLUB

Field Data
EIN 81-4557438
Case Number EO-2017033-000164
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRIME TIGER TAEKWONDO BOOSTER CLUB
Organization’s Mailing Address 925 NE WOODS CHAPEL RD
City LEES SUMMIT
State MO
ZIP 64064
Accounting period End 8
Primary contact name JAMAICA COLLINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMAICA COLLINS
PRESIDENT
2932 OLIVE
KANSAS CITY MO 64109

Officer/Director/Trustee Two

MELISSA HARDY
TREASURER
2436 NE INDIAN CIRCLE
LEE'S SUMMIT MO 64086

Officer/Director/Trustee Three

AMY BAKER
SECRETARY
4009 SW WASHINGTON DR
BLUE SPRINGS MO 64014

Officer/Director/Trustee Four

DOUGLAS EKBERG JR
FUNDRAISING/ACTIVITY COORDINATOR
1413 S RANDALL RD
INDEPENDENCE MO 64055

Officer/Director/Trustee Five

VIRGINIA PENNINGTON
PARENT/STUDENT LIASON
10119 E 79TH STREET
RAYTOWN MO 64138

Organization’s website HTTP://PRIMETIGERBOOSTERS.CH2V.COM
Organization’s email TIGERBOOSTERS16@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2016
Organization Incorporation State MO
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: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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