FORM 1023-EZ for HRHS GIRLS SWIM & DIVE BOOSTER CLUBINC

Field Data
EIN 83-2847617
Case Number EO-2019029-000332
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HRHS GIRLS SWIM & DIVE BOOSTER CLUBINC
Organization’s Mailing Address 8228 LODGEPOLE TRAIL
City LONE TREE
State CO
ZIP 80124
Accounting period End 6
Primary contact name HRHS GIRLS SWIM & DIVE BOOSTER CL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLLY JACOB
TREASURER
8228 LODGEPOLE TRAIL
LONE TREE CO 80124

Officer/Director/Trustee Two

CHERYL BURTON
SECRETARY
9480 YALE LN
HIGHLANDS RANCH CO 80130

Officer/Director/Trustee Three

JEANNE LARIVIERE
PRESIDENT
9651 ADELAIDE CIRCLE
HIGHLANDS RANCH CO 80130

Officer/Director/Trustee Four

KENNETH NOLLSCH
VICE PRESIDENT
9353 LARK SPARROW DR
HIGHLANDS RANCH CO 80126

Officer/Director/Trustee Five

KELEIGH THOMPSON
MEMBER AT LARGE
9210 S CEDAR HILL WAY
LONE TREE CO 80124

Organization’s website
Organization’s email HRHSSWIMBOOSTER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
Organization’s purpose Charitable: Yes
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 HOLLY JACOB
Signature Title TREASURER
Signature Date 12/17/18

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