FORM 1023-EZ for KNIGHTS CROSS COUNTRY BOOSTER CLUB

Field Data
EIN 45-3785404
Case Number EO-2014252-000079
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KNIGHTS CROSS COUNTRY BOOSTER CLUB
Organization’s Mailing Address 720 PLEASANT ST
City SOUTHINGTON
State CT
ZIP 06489
Accounting period End 3
Primary contact name JOHN MYERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN MYERS
PRESIDENT
1000 EAST ST
SOUTHINGTON CT 06489

Officer/Director/Trustee Two

MIKE PERKOWSKI
VP
102 SAVAGE ST
PLANTSVILLE CO 06479

Officer/Director/Trustee Three

JANIQUE SIMARD
TREASURER
29 WILLOW DOLE DR
SOUTHINGTON CT 06489

Officer/Director/Trustee Four

HOLLY HAMEL
CORRESPONDING SECRETARY
51 CARDINAL DR
PLANTSVILLE CT 06479

Officer/Director/Trustee Five

SUSAN MURPHY
RECORDING SECRETARY
282 PIN OAK DR
SOUTHINGTON CT 06489

Organization’s website SOUTHINGTONXC.COM
Organization’s email SOUTHINGTONXC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2011
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
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 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 Yes
Signature Name
Signature Title
Signature Date

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