FORM 1023-EZ for ESA ATHLETIC BOOSTER CLUB

Field Data
EIN 82-1754506
Case Number EO-2018031-000209
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ESA ATHLETIC BOOSTER CLUB
Organization’s Mailing Address 590 TRADITIONS GRANDE BLVD
City WAKE FOREST
State NC
ZIP 27587
Accounting period End 6
Primary contact name MICHELE ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENNIS GASKINS
PRESIDENT
3705 WILLOW STONE LANE
WAKE FOREST NC 27587

Officer/Director/Trustee Two

SHARON TAZEWELL
VICE PRESIDENT
2236 RAINY LAKE STREET
WAKE FOREST NC 27587

Officer/Director/Trustee Three

MICHELE ADAMS
TREASURER
1413 BALLYCLARE COURT
RALEIGH NC 27614

Officer/Director/Trustee Four

ERIN IRVIN
SECRETARY
115 LEAF SPRING
YOUNGSVILLE NC 27596

Organization’s website HTTPS://ESAATHLETICBOOSTERS.WEEBLY.COM
Organization’s email BOOSTERS@ENVISIONSCIENCEACADEMY.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/17
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 MICHELE ADAMS
Signature Title TREASURER
Signature Date 1/29/18

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