FORM 1023-EZ for MADISON SOCCER BOOSTER CLUB

Field Data
EIN 61-1135265
Case Number EO-2016333-000171
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MADISON SOCCER BOOSTER CLUB
Organization’s Mailing Address PO BOX 4021
City MADISON
State CT
ZIP 06443
Accounting period End 12
Primary contact name CAMILLE MURPHY CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN GULICEK
CO-PRESIDENT
100 NURSERY LANE
MADISON CT 06443

Officer/Director/Trustee Two

MICHELE LICURSI
CO-PRESIDENT
10 OAK AVENUE
MADISON CT 06443

Officer/Director/Trustee Three

MELANIE HARTMANN
VICE PRESIDENT
57 SQUIRES ROAD
MADISON CT 06443

Officer/Director/Trustee Four

SUSAN RUGGIERO
SECRETARY
43 MADISON SPRINGS DRIVE
MADISON CT 06443

Officer/Director/Trustee Five

WARREN HARTMANN
TREASURER
57 SQUIRES ROAD
MADISON CT 06443

Organization’s website DHHSBOYSSOCCER.BLOGSPOT.COM
Organization’s email DHHSBOYSSOCCER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/1985
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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