FORM 1023-EZ for ROCK AND ROLL OVER BRAIN CANCER INC

Field Data
EIN 47-1321383
Case Number EO-2015135-000043
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROCK AND ROLL OVER BRAIN CANCER INC
Organization’s Mailing Address 5219 GILLETTE AVE
City HILLIARD
State OH
ZIP 43026-8845
Accounting period End 12
Primary contact name MARY K FENLON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARY FENLON
PRESIDENT
85 CRESSINGHAM LN
POWELL OH 43065-6661

Officer/Director/Trustee Two

KATHY LANDES
SECRETARY
466 CROSSINGS DR
WESTERVILLE OH 43082-6339

Officer/Director/Trustee Three

KATIE MYERS
TREASURER
5219 GILLETTE AVE
HILLIARD OH 43026-8845

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2014
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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