FORM 1023-EZ for ARIZONA BLOCKCHAIN INITIATIVE
| Field | Data |
|---|---|
| EIN | 82-4105513 |
| Case Number | EO-2018024-000310 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | ARIZONA BLOCKCHAIN INITIATIVE |
| Organization’s Mailing Address | 3033 E THUNDERBIRD RD UNIT 2050 |
| City | PHOENIX |
| State | AZ |
| ZIP | 85032 |
| Accounting period End | 12 |
| Primary contact name | MELISSA P ROBERTS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MELISSA ROBERTS
DIRECTOR, CEO, CO-FOUNDER
3033 EAST THUNDERBIRD RD 2050
PHOENIX AZ 85032-8615
Officer/Director/Trustee Two
BRIAN WEAVER
DIRECTOR, COO, CO-FOUNDER
515 E GRANT ST
PHOENIX AZ 85004-2750
Officer/Director/Trustee Three
LESLIE PICO
DIRECTOR
515 E GRANT ST
PHOENIX AZ 85004-2750
| Organization’s website | AZBLOCKCHAIN.ORG |
|---|---|
| Organization’s email | CONNECT@AZBLOCKCHAIN.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/26/17 |
| Organization Incorporation State | AZ |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B01 - Alliance/Advocacy Organizations |
| 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 | Yes |
| 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 | No |
| 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 | MELISSA ROBERTS |
| Signature Title | DIRECTOR, CEO, CO-FOUNDER |
| Signature Date | 1/22/18 |
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