FORM 1023-EZ for BLACKOUT ACADEMY INC
| Field | Data |
|---|---|
| EIN | 82-4446218 |
| Case Number | EO-2018053-000288 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BLACKOUT ACADEMY INC |
| Organization’s Mailing Address | 5120 SALT TRAIL CANYON PASS |
| City | FORT WAYNE |
| State | IN |
| ZIP | 46808 |
| Accounting period End | 12 |
| Primary contact name | DR KANDY MORRELL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
RICHARD THOMAS
PRESIDENT
5120 SALT TRAIL CANYON PASS
FORT WAYNE IN 46808
Officer/Director/Trustee Two
TONYA THOMAS
DIRECTOR
5120 SALT TRAIL CANYON PASS
FORT WAYNE IN 46808
Officer/Director/Trustee Three
CLIFTON DIAL
VICE PRESIDENT
3412 BEATRICE DRIVE
FORT WAYNE IN 46086
Officer/Director/Trustee Four
ADRIENNE SANTOS
SECRETARY
4645 SOUTH PARK DRIVE
FORT WAYNE IN 46806
Officer/Director/Trustee Five
TANISHA COOPER
TREASURER
6037 ULLYOT DRIVE
FORT WAYNE IN 46804
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/16/18 |
| Organization Incorporation State | IN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O50 - Youth Development Programs, Other |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No 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 | 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 | RICHARD THOMAS |
| Signature Title | PRESIDENT |
| Signature Date | 2/20/18 |
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