FORM 1023-EZ for FROG ROCK YOUTH CAMP INC

Field Data
EIN 84-2978581
Case Number EO-2019259-000761
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FROG ROCK YOUTH CAMP INC
Organization’s Mailing Address 1894 E WILLIAMS STREET STE 4 349
City CARSON CITY
State NV
ZIP 89701
Accounting period End 12
Primary contact name PAULA DAUBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULA DAUBER
PRESIDENT, DIRECTOR, TREASURER
700 HIGHLAND STREET
CARSON CITY NV 89703

Officer/Director/Trustee Two

DAVE RIKALO
DIRECTOR
7960 TERUEL CT
SPARKS NV 89436

Officer/Director/Trustee Three

WHITNEY RIKALO
SECRETARY/DIRECTOR
7960 TERUEL CT
SPARKS NV 89436

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/19
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
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 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 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 PAULA DAUBER
Signature Title PRESIDENT, DIRECTOR, TREASURER
Signature Date 9/12/19

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