FORM 1023-EZ for NORTHERN KENTUCKY BLUEGRASS MUSIC ASSOCIATION

Field Data
EIN 20-8397276
Case Number EO-2018299-000172
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTHERN KENTUCKY BLUEGRASS MUSIC ASSOCIATION
Organization’s Mailing Address PO BOX 133
City HEBRON
State KY
ZIP 41048
Accounting period End 12
Primary contact name PAMELA BUSHELMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAMELA BUSHELMAN
PRESIDENT
2263 WALLER RD
VERONA KY 41092

Officer/Director/Trustee Two

GENE THOMPSON
VICE PRESIDENT
1913 HART DR
HEBRON KY 41048

Officer/Director/Trustee Three

MYRNA MURPHY
TREASURER
3124 ROBIN CT
HEBRON KY 41048

Officer/Director/Trustee Four

TOM BUSHELMAN
SECRETARY
2263 WALLER RD
VERONA KY 41092

Officer/Director/Trustee Five

RON SIMMONS
SENIOR ADVISOR
13970 E FAGINS RUN LOOP
NEW RICHMOND OH 45157

Organization’s website WWW.NKBMA.COM
Organization’s email PBUSHELMAN@NKBMA.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/05
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
Organization’s purpose Charitable: No
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 No
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name PAMELA BUSHELMAN
Signature Title PRESIDENT
Signature Date 10/24/18

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