FORM 1023-EZ for VIPERS BASKETBALL TEAM

Field Data
EIN 35-2449625
Case Number EO-2017044-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VIPERS BASKETBALL TEAM
Organization’s Mailing Address 4231 HILLTOP NEEDMORE RD
City FUQUAY VARINA
State NC
ZIP 27526-9254
Accounting period End 12
Primary contact name ANGELA PERKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACY PERKNS
PRESIDENT
216 ROCKY POINT CT
FUQUAY VARINA NC 27526-4975

Officer/Director/Trustee Two

BRIAN BROOKS
VICE PRESIDENT
1620 MAIZEFIELD LN
FUQUAY VARINA NC 27256-7953

Officer/Director/Trustee Three

CHARLES BAKER JR
ADMINISTRATOR
9420 PURFOY RD
FUQUAY VARINA NC 27526-8966

Officer/Director/Trustee Four

MELVIN HEGGIE
ADMINISTRATOR
4231 HILLTOP NEEDMORE RD
FUQUAY VARINA NC 27526-9254

Officer/Director/Trustee Five

ANGELA PERKINS
ADMINISTRATOR/SECRETARY
216 ROCKY POINT CT
FUQUAY VARINA NC 27526-4975

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/16/2012
Organization Incorporation State NC
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 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
Signature Title
Signature Date

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