FORM 1023-EZ for RAN BLAKE FOUNDATION INC

Field Data
EIN 82-3846874
Case Number EO-2018171-000339
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RAN BLAKE FOUNDATION INC
Organization’s Mailing Address 77 FLORENCE STREET
City ROSLINDALE
State MA
ZIP 2131
Accounting period End 12
Primary contact name DAVID S MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AARON HARTLEY
DIRECTOR AND PRESIDENT
77 FLORENCE STREET
ROSLINDALE MA 2131

Officer/Director/Trustee Two

GARDINER HARTMANN
DIRECTOR AND TREASURER
49 RUTLAND STREET
BOSTON MA 2118

Officer/Director/Trustee Three

EDEN MACADAM-SOMER
DIRECTOR AND SECRETARY
77 FLORENCE STREET
ROSLINDALE MA 2131

Officer/Director/Trustee Four

ALICE RUSSELL
DIRECTOR
71 PERKINS STREET NUMBER 4
JAMAICA PLAIN MA 2130

Officer/Director/Trustee Five

DAVID FABRIS
DIRECTOR
70 LAUREL PLACE
NEW ROCHELLE NY 10801

Organization’s website WWW.RANBLAKEFOUNDATION.ORG
Organization’s email AARON@RANBLAKEFOUNDATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/17
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A99 - Arts, Culture, and Humanities N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Donation of funds Yes
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 AARON HARTLEY
Signature Title DIRECTOR AND PRESIDENT
Signature Date 6/6/18

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