FORM 1023-EZ for BAND OF BLUE INC

Field Data
EIN 47-5544887
Case Number EO-2016314-000236
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BAND OF BLUE INC
Organization’s Mailing Address 8326 190 AVENUE
City BRISTOL
State WI
ZIP 53104-9258
Accounting period End 12
Primary contact name MICHAEL E SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL SMITH
PRESIDENT AND TREASURER
8326 190 AVENUE
BRISTOL WI 53104-9258

Officer/Director/Trustee Two

SARAH SMITH
VICE-PRESIDENT
8326 190 AVENUE
BRISTOL WI 53104-9258

Officer/Director/Trustee Three

TARA PANASEWICZ
SECRETARY
5524 67 STREET
KENOSHA WI 53142-1507

Officer/Director/Trustee Four

JOSH OMALLEY
DIRECTOR
E2580 KIRK DRIVE
EAU CLAIRE WI 54701-9647

Officer/Director/Trustee Five

KATIE OMALLEY
DIRECTOR
E2580 KIRK DRIVE
EAU CLAIRE WI 54701-9647

Organization’s website WWW.BANDBLUE.ORG
Organization’s email INFO@BANDBLUE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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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