FORM 1023-EZ for WEST JESSAMINE FOOTBALL BOOSTERS

Field Data
EIN 83-1057779
Case Number EO-2020275-000099
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WEST JESSAMINE FOOTBALL BOOSTERS
Organization’s Mailing Address 1400 WILMORE RD
City NICHOLASVILLE
State KY
ZIP 40356
Accounting period End 6
Primary contact name RACHEL MIERSMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLIFF SWAIM
PRESIDENT
408 N KEENE WAY DR
NICHOLASVILLE KY 40356

Officer/Director/Trustee Two

SHAWN UMBRELL
VICE-PRESIDENT
107 PARKER LANE
NICHOLASVILLE KY 40356

Officer/Director/Trustee Three

AMY PAGE
SECRETARY
1410 JESSAMINE STATION PIKE
NICHOLASVILLE KY 40356

Officer/Director/Trustee Four

RACHEL MIERSMA
TREASURER
101 CUSHINGBERRY LANE
KEENE KY 40339

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2018
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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 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 RACHEL MIERSMA
Signature Title TREASURER
Signature Date 9/28/2020

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