FORM 1023-EZ for SELF DEFENSE TRAINING AND RANGE GROUP

Field Data
EIN 85-0548093
Case Number EO-2020098-000084
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SELF DEFENSE TRAINING AND RANGE GROUP
Organization’s Mailing Address PO BOX 1276
City OKANOGAN
State WA
ZIP 98840
Accounting period End 12
Primary contact name MICHAEL BLAKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL BLAKE
CHAIRMAN
1069 2ND AVE S
OKANOGAN WA 98840

Officer/Director/Trustee Two

STEFAN WOLAK
BOARD MEMBER
72B LIBBY CREEK RD
CARLTON WA 98814

Officer/Director/Trustee Three

ROBERT THOMAS
BOARD MEMBER
3 CHIEF JOSEPH SPUR RD W
RIVERSIDE WA 98849

Officer/Director/Trustee Four

JIM MORGAN
BOARD MEMBER
429 PINE CREEK RD
TONASKET WA 98855

Officer/Director/Trustee Five

RICARDO COVARRUBIAS
BOARD MEMBER
405 CENTRAL AVE
OROVILLE WA 98844

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2020
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 MICHAEL BLAKE
Signature Title CHAIRMAN
Signature Date 4/1/2020

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