FORM 1023-EZ for KHS GIRLS BASKETBALL BOOSTER CLUB

Field Data
EIN 20-3218747
Case Number EO-2016315-000417
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KHS GIRLS BASKETBALL BOOSTER CLUB
Organization’s Mailing Address 43 ARCH STREET
City KEENE
State NH
ZIP 03431
Accounting period End 6
Primary contact name JENNIFER PELLERIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBRA HUNTER
PRESIDENT
28B STONEHOUSE LANE
KEENE NH 03431

Officer/Director/Trustee Two

JENNIFER PELLERIN
TREASURER
257 PAKO AVE
KEENE NH 03431

Officer/Director/Trustee Three

LYNETTE SOUCIA
VICE PRESIDENT
38 KNOWLTON ST
MARLBOROUGH NH 03455

Officer/Director/Trustee Four

MARY WHITE
VICE PRESIDENT
PO BOX 552
WEST CHESTERFIELD NH 03466

Officer/Director/Trustee Five

JULIE FARHM
SECRETARY
1104 JAFFREY RD
MARLBOROUGH NH 03455

Organization’s website
Organization’s email GIRLSKHSBB@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/22/2016
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 Yes
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
Signature Title
Signature Date

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