FORM 1023-EZ for ROCK BLUE

Field Data
EIN 46-5641849
Case Number EO-2015107-000343
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROCK BLUE
Organization’s Mailing Address 1306 N EDISON ST
City ARLINGTON
State VA
ZIP 22205
Accounting period End 12
Primary contact name IAN PHILLIPS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PETER MACY
PRESIDENT/DIRECTOR
1306 N EDISON ST
ARLINGTON VA 22205

Officer/Director/Trustee Two

SATISH MENON
UTILITY OUTREACH DIRECTOR
603 W ADDISON AVE 3
CHICAGO IL 60613

Officer/Director/Trustee Three

RICH NOTH
FINANCIAL DIRECTOR
12569 SUMMIT MANOR DR 303
FAIRFAX VA 22033

Officer/Director/Trustee Four

IAN PHILLIPS
ORGANIZATIONAL DIRECTOR
16-40 STEPHEN ST 2
FLUSHING NY 11385

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2013
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W02 - Management & Technical Assistance
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 Yes
Conducting Activities Outside of United States Yes
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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