FORM 1023-EZ for LADY BEARS BASKETBALL BOOSTER CLUB

Field Data
EIN 85-4053394
Case Number EO-2021021-000226
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LADY BEARS BASKETBALL BOOSTER CLUB
Organization’s Mailing Address 9800 DARTMOUTH PLACE
City LAKEWOOD
State CO
ZIP 80227
Accounting period End 4
Primary contact name KELIN CLEMENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELIN CLEMENT
PRESIDENT
2053 S DOWNING STREET
DENVER CO 80210

Officer/Director/Trustee Two

VAL HODGE
VICE PRESIDENT
9523 WEST CROSS PLACE
LITTLETON CO 80123

Officer/Director/Trustee Three

ALICE CLEMENT
TREASURER
6104 BELMONT WAY
PARKER CO 80134

Officer/Director/Trustee Four

RACHEL CORNETT
SECRETARY
1553 S ROSLYN STREET
DENVER CO 80231

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/2020
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KELIN CLEMENT
Signature Title PRESIDENT
Signature Date 11/29/2020

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