FORM 1023-EZ for QUILCENE BOOSTER CLUB

Field Data
EIN 91-1025087
Case Number EO-2021274-000059
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name QUILCENE BOOSTER CLUB
Organization’s Mailing Address PO BOX 501
City QUILCENE
State WA
ZIP 98376
Accounting period End 12
Primary contact name DENISE MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENISE MILLER
PRESIDENT
1781 DABOB RD
QUILCENE WA 98376

Officer/Director/Trustee Two

LORNA WARD
VICE PRESIDENT
41 MCARDLE
QUILCENE WA 98376

Officer/Director/Trustee Three

KATHLEEN KIEFFER-ROMBOKAS
SECRETARY
297694 US HIGHWAY 101
QUILCENE WA 98376

Officer/Director/Trustee Four

JACQUE BANCROFT
TREASURER
110 OLD STATE HIGHWAY
QUILCENE WA 98376

Organization’s website
Organization’s email QUILCENEBOOSTERCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/2020
Organization Incorporation State WA
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: 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name DENISE MILLER
Signature Title PRESIDENT
Signature Date 9/29/2021

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