FORM 1023-EZ for FABULOUS SIN CITY JUNIOR ROLLERS

Field Data
EIN 36-4841975
Case Number EO-2016263-000507
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FABULOUS SIN CITY JUNIOR ROLLERS
Organization’s Mailing Address POST OFFICE BOX 848 NORTH RAINBOW
City LAS VEGAS
State NV
ZIP 89107-1103
Accounting period End 12
Primary contact name HEATHER RIBARSKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHERYL POTTER
PRESIDENT
7211 HEGGIE AVENUE
LAS VEGAS NV 89131-3233

Officer/Director/Trustee Two

CHARLES PAYNE
TREASURER
811 PARK LANE
HENDERSON NV 89015-5722

Officer/Director/Trustee Three

HEATHER RIBARSKY
SECRETARY
7400 MAIDEN RUN AVENUE
LAS VEGAS NV 89130-1057

Officer/Director/Trustee Four

RYAN SCHLOSSER
DIRECTOR/BOARD MEMBER
4300 FULTON PLACE
LAS VEGAS NV 89107-4151

Officer/Director/Trustee Five

MEGAN WALLACE
BOARD MEMBER
5695 WEST ROCHELLE AVENUE 202
LAS VEGAS NV 89103-3460

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/2016
Organization Incorporation State NV
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
Signature Title
Signature Date

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