FORM 1023-EZ for BROKEN SPOKE

Field Data
EIN 47-4202642
Case Number EO-2017102-000284
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROKEN SPOKE
Organization’s Mailing Address 1075 MANDI CT / PO BOX 2027
City NIPOMO
State CA
ZIP 93444
Accounting period End 12
Primary contact name DUDLEY VENABLE JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERESA VENABLE
COUNSEL PRESIDENT
1075 MANDI CT
NIPOMO CA 93444

Officer/Director/Trustee Two

WILLIAM HOCH
SECRETARY
7346 RIO FLORA PLACE
DOWNEY CA 90241

Officer/Director/Trustee Three

DUDLEY VENABLE
TREASURER
1075 MANDI CT
NIPOMO CA 93444

Organization’s website
Organization’s email BROKENSPOKE1@OUTLOOK.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2015
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P44 - Homemaker, Home Health Aide
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 Yes
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 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
Signature Title
Signature Date

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