FORM 1023-EZ for CAMPBELL BOYS LACROSSE BOOSTER CLUB

Field Data
EIN 85-4360222
Case Number EO-2021035-000034
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAMPBELL BOYS LACROSSE BOOSTER CLUB
Organization’s Mailing Address 5265 WARD ST SE
City SMYRNA
State GA
ZIP 30080
Accounting period End 7
Primary contact name KATE WILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY BODNER
PRESIDENT
3020 VINEYARD WAY
SMYRNA GA 30082

Officer/Director/Trustee Two

JENNIFER WILLIAMS
VICE-PRESIDENT
413 DOWNFIELD WAY
SMYRNA GA 30082

Officer/Director/Trustee Three

KATHERINE WILEY
TREASURER
1859 VININGS MILL WALK SE
SMYRNA GA 30080

Organization’s website
Organization’s email CAMPBELL.LAX.ACCTG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
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 KATHERINE WILEY
Signature Title TREASURER
Signature Date 12/21/2020

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