FORM 1023-EZ for SPORTS BOOST FOUNDATION INC

Field Data
EIN 85-3611647
Case Number EO-2021133-000156
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SPORTS BOOST FOUNDATION INC
Organization’s Mailing Address PO BOX 2142
City CLACKAMAS
State OR
ZIP 97015
Accounting period End 12
Primary contact name SVETLANA TASKAEVA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RYAN MENTEN
PRESIDENT & DIRECTOR
20354 SW NAVARRE LANE
BEAVERTON OR 97007

Officer/Director/Trustee Two

DAVE WALKER
VICE PRESIDENT
14662 SE POPPY HILLS DRIVE
HAPPY VALLEY OR 97086

Officer/Director/Trustee Three

CHRIS RIVERS
TREASURER
PO BOX 2142
CLACKAMAS OR 97015

Officer/Director/Trustee Four

JIM GATTO
SECRETARY
PO BOX 2142
CLACKAMAS OR 97015

Organization’s website
Organization’s email RYAN.MENTEN@HOOPSOURCEBASKETBALL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
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 RYAN MENTEN
Signature Title PRESIDENT & DIRECTOR
Signature Date 5/11/2021

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