FORM 1023-EZ for BILL ROSE MEMORIAL FUNDRAISER FOR MELANOMA INC

Field Data
EIN 82-4466662
Case Number EO-2018052-000272
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BILL ROSE MEMORIAL FUNDRAISER FOR MELANOMA INC
Organization’s Mailing Address 13137 NITTANY LION CIR
City HAGERSTOWN
State MD
ZIP 21740
Accounting period End 12
Primary contact name BARBARA ROSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEREK ISENSEE
VP
12101 MAGNOLIA PARK PLACE
CLARKSBURG MD 20871

Officer/Director/Trustee Two

DEBORAH BECK
SECRATARY
12101 MAGNOLIA PARK PLACE
CLARKSBURG MD 20871

Officer/Director/Trustee Three

SHERRI WRIGHT
SECRETARY
4231 FORDING CREEK RD
GREENCASTLE PA 17225

Officer/Director/Trustee Four

CRAIG WRIGHT
ALT SECRETARY
4231 FORDING CREEK RD
GREENCASTLE PA 17225

Officer/Director/Trustee Five

BARBARA ROSE
PRESIDENT
13137 NITTANY LION CIR
HAGERSTOWN MD 21740

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/7/18
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - Fund Raising and/or Fund Distribution
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 Yes
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 BARBARA ROSE
Signature Title PRESIDENT
Signature Date 2/19/18

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