FORM 1023-EZ for BEASTS OBSTACLE COURSE RACER

Field Data
EIN 83-1669817
Case Number EO-2018236-000398
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BEASTS OBSTACLE COURSE RACER
Organization’s Mailing Address 1405 S 262ND ST
City DES MOINES
State WA
ZIP 98198
Accounting period End 12
Primary contact name ADAM BIRGENHEIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADAM BIRGENHEIER
PRESIDENT
1405 S 262ND ST
DES MOINES WA 98198

Officer/Director/Trustee Two

ZANE KNEPPER
VICE PRSIDENT
9313 NE 109TH AVE
VANCOUVER WA 98662

Officer/Director/Trustee Three

JANELL ENDO
SECRETARY
531 BERKELEY AVE
FIRCREST WA 98466

Officer/Director/Trustee Four

RON BROTHERS JR
TREASURER
19244 136TH PL SE
RENTON WA 98058

Organization’s website BEASTSOCR.ORG
Organization’s email ADAMB@BEASTSOBSTACLECOURSERACERS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 ADAM BIRGENHEIER
Signature Title PRESIDENT
Signature Date 8/22/18

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