FORM 1023-EZ for ROUGH DIAMOND REBELS ROLLER DERBY

Field Data
EIN 47-4336319
Case Number EO-2016274-000130
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROUGH DIAMOND REBELS ROLLER DERBY
Organization’s Mailing Address 27428 PINYON STREET
City MURIETTA
State CA
ZIP 92562
Accounting period End 12
Primary contact name STEPHANIE OLIVAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE OLIVAS
PRESIDENT/OWNER
27428 PINYON STREET
MURIETTA CA 92562

Officer/Director/Trustee Two

HEATHER ADAMS
VICE PRESIDENT
27428 PINYON STREET
MURIETTA CA 92562

Officer/Director/Trustee Three

JENN SOUTHERN
TREASURER
27428 PINYON STREET
MURIETTA CA 92562

Officer/Director/Trustee Four

JOAN MONTANO
TRAINING COORDINATOR
27428 PINYON STREET
MURIETTA CA 92562

Organization’s website INFO@ROUGHDIAMONDREBELS.COM
Organization’s email PRESIDENTRDR@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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