FORM 1023-EZ for 12TH MAN-GO BLUE INC

Field Data
EIN 47-4211798
Case Number EO-2015161-000536
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 12TH MAN-GO BLUE INC
Organization’s Mailing Address PO BOX 542
City DALTON
State MA
ZIP 01227-0542
Accounting period End 6
Primary contact name MARGHERITA HOFFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEVE CLAYTON
PRESIDENT
139 PLEASANT ST
DALTON MA 01226

Officer/Director/Trustee Two

MARGHERITA HOFFMAN
TREASURER
51 GEORGE SCHNOPP RD
HINSDALE MA 01235

Officer/Director/Trustee Three

SUSAN MORRISON
SECRETARY/CLERK
60 ANTHONY RD
DALTON MA 01226

Officer/Director/Trustee Four

MICHAEL SMITH
DIRECTOR
89 PLEASANT ST
DALTON MA 01226

Officer/Director/Trustee Five

GARY CAMPBELL JR
DIRECTOR
8 MARLOW DR
PERU MA 01235

Organization’s website WWW.12THMAN-GOBLUE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
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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