FORM 1023-EZ for CHAMPIONS BOOSTER OF LAVEEN INC

Field Data
EIN 47-3357288
Case Number EO-2015072-000773
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAMPIONS BOOSTER OF LAVEEN INC
Organization’s Mailing Address 7117 S 68TH AVE
City LAVEEN
State AZ
ZIP 85339
Accounting period End 12
Primary contact name RENEE DOMINGUEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEVIN SKAFF
PRESIDENT
7117 S 68TH AVE
LAVEEN AZ 85339

Officer/Director/Trustee Two

NOLA TALAUEGA
VICE PRESIDENT
7247 WEST SAINT CHARLES AVENUE
LAVEEN AZ 85339

Officer/Director/Trustee Three

LUIS GALLARDO
TREASURER
5645 W CAMBELBACK ROAD
PHOENIX AZ 85031

Officer/Director/Trustee Four

RENEE DOMINGUEZ
SECRETARY
4000 WEST GRANT ST
PHOENIX AZ 85009-5312

Organization’s website HTTP://CHAVEZCHAMPIONSFOOTBALL.COM
Organization’s email CHAVEZFOOTBALL85339@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/2015
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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