FORM 1023-EZ for STORM LAKE COMMUNITY SCHOOL YOUTH MENTORING BOOSTERS INC

Field Data
EIN 83-2073741
Case Number EO-2019031-000906
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STORM LAKE COMMUNITY SCHOOL YOUTH MENTORING BOOSTERS INC
Organization’s Mailing Address 1811 HYLAND DR
City STORM LAKE
State IA
ZIP 50588-2800
Accounting period End 6
Primary contact name ELIZABETH SPECKETER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL JONES
PRESIDENT
101 EVERGREEN DR
ALTA IA 51002-7605

Officer/Director/Trustee Two

ELIZABETH SPECKETER
VICE PRESIDENT
5163 100TH AVE
REMBRANDT IA 50576-7547

Officer/Director/Trustee Three

JENNIFER HECHT
TREASURER
1005 LIGHTHOUSE DR
STORM LAKE IA 50588-1626

Officer/Director/Trustee Four

CHELSEA BAKER
SECRETARY
1108 KELVIN RD APT 3
STORM LAKE IA 50588-2765

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/27/18
Organization Incorporation State IA
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: 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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ELIZABETH SPECKETER
Signature Title VICE PRESIDENT
Signature Date 1/8/19

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