FORM 1023-EZ for BLACKFORD BANDS BOOSTER

Field Data
EIN 85-1314789
Case Number EO-2020161-000106
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACKFORD BANDS BOOSTER
Organization’s Mailing Address 7615 CANTERCHASE CT APT 3C
City FORT WAYNE
State IN
ZIP 46804
Accounting period End 12
Primary contact name AARON M HENDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLDEN BERLIN
PRESIDENT
7615 CANTERSHASE CT 3C
FORT WAYNE IN 46804

Officer/Director/Trustee Two

LORNA MANLEY
SEC/TRES
6 MCCREE CT
HARTFORD CITY IN 47348

Officer/Director/Trustee Three

AARON HENDERSON
LEGAL REPRESENTATIVE
502 W MAIN STREET
HARTFORD CITY IN 47348

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - 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 AARON HENDERSON
Signature Title LEGAL REPRESENTATIVE
Signature Date 6/5/2020

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