FORM 1023-EZ for BLUE ROCK COUNSELING COACHING INC

Field Data
EIN 47-5545200
Case Number EO-2016063-000154
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE ROCK COUNSELING COACHING INC
Organization’s Mailing Address 1870 OSCAR FRYE ROAD
City PINNACLE
State NC
ZIP 27043
Accounting period End 12
Primary contact name DIANA B BRYANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DIANA BRYANT
PRESIDENT
1870 OSCAR FRYE ROAD
PINNACLE NC 27043

Officer/Director/Trustee Two

PHILIP BRYANT
SECRETARY/TRESURER
1870 OSCAR FRYE ROAD
PINNACLE NC 27043

Organization’s website WWW.BLUEROCKCOUNSELINGANDCOACHING.ORG
Organization’s email BLUEROCKCOUNSELING@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: Yes
Religious: Yes
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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