FORM 1023-EZ for BLACK AND BLUEGRASS ROLLERGIRLS INC

Field Data
EIN 83-4019137
Case Number EO-2019080-000308
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK AND BLUEGRASS ROLLERGIRLS INC
Organization’s Mailing Address 5040 OLD TAYLOR MILL RD STE 21
City TAYLOR MILL
State KY
ZIP 41015
Accounting period End 12
Primary contact name NICHOLAS FAUSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHELLE DAVIS
DIRECTOR
2331 DOUBLEGATE LANE
BURLINGTON KY 41005

Officer/Director/Trustee Two

DIANA DOYLE
DIRECTOR
3274 PICKBURRY DRIVE
CINCINNATI OH 45211

Officer/Director/Trustee Three

EMILY THOMPSON
DIRECTOR
6967 LAWYER RD
CINCINNATI OH 45244

Officer/Director/Trustee Four

ERIKA RAVENSCRAFT
DIRECTOR
683 EUCLID AVE
CRESCENT SPRINGS KY 41017

Officer/Director/Trustee Five

GINA GROESCHEN
DIRECTOR
151 ORCHARD LANE
ALEXANDRIA KY 41042

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/19
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 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 RICHELLE DAVIS
Signature Title DIRECTOR
Signature Date 3/18/19

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