FORM 1023-EZ for BEYOND BLUE FOUNDATION INC

Field Data
EIN 47-2560451
Case Number EO-2015035-000323
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BEYOND BLUE FOUNDATION INC
Organization’s Mailing Address 519 THIRD STREET
City ANNAPOLIS
State MD
ZIP 21403-3210
Accounting period End 12
Primary contact name THERESE BORCHARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT ROSE
PRESIDENT
8409 STONEHOUSE ROAD
FREDERICK MD 21702

Officer/Director/Trustee Two

JOHN GROHOL
VICE-PRESIDENT
15 EVERGREEN LANE
GROVELAND MA 01834

Officer/Director/Trustee Three

TOM SEEBURG
VICE-PRESIDENT
1018 ADELAIDE DRIVE
NORTHBROOK IL 60062

Officer/Director/Trustee Four

RACHAEL BARRETT
SECRETARY TREASURER
9412 FORT HAMILTON PARKWAY
BROOKLYN NY 11209

Officer/Director/Trustee Five

THERESE BORCHARD
EXECUTIVE DIRECTOR
519 THIRD STREET
ANNAPOLIS MD 21403-3210

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2014
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
Organization’s purpose Charitable: Yes
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 No
One Third Support Gifts Yes
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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