FORM 1023-EZ for JOHN I BURTON LADY RAIDERS BASKETBALL BOOSTERS

Field Data
EIN 87-1372051
Case Number EO-2021242-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JOHN I BURTON LADY RAIDERS BASKETBALL BOOSTERS
Organization’s Mailing Address 5838 POWELL VALLEY RD
City BIG STONE GAP
State VA
ZIP 24219
Accounting period End 6
Primary contact name BELLA PHIPPS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BELLA PHIPPS
TREASURER
5838 POWELL VALLEY RD
BIG STONE GAP VA 24219

Officer/Director/Trustee Two

NIKKI OSBORNE
PRESIDENT
219 CHESTNUT ST
NORTON VA 24273

Officer/Director/Trustee Three

TINA SENSABAUGH
VICE PRESIDENT
9211 MOUNTAIN LAUREL ST
WISE VA 24293

Officer/Director/Trustee Four

CRYSTAL STURGILL
SECRETARY
103 4TH ST NW
NORTON VA 24273

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration No
Signature Name BELLA PHIPPS
Signature Title TREASURER
Signature Date 8/26/2021

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