FORM 1023-EZ for BRK RETREAT

Field Data
EIN 84-1976936
Case Number EO-2019157-000349
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRK RETREAT
Organization’s Mailing Address 623 E SAN JOSE AVE
City BURBANK
State CA
ZIP 91501
Accounting period End 12
Primary contact name TESSA ELINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TESSA ELINE
TREASURER
2805 GLENMORE AVE
PITTSBURGH PA 15216

Officer/Director/Trustee Two

RACHEL BARISH
PRESIDENT
623 E SAN JOSE AVE
BURBANK CA 91501

Officer/Director/Trustee Three

TINA TSE
SECRETARY
38099 SCHOENHERR RD
STERLING HEIGHTS MI 48312

Organization’s website WWW.BORNANDRAISEDKNITS.COM/BRK-RETREAT
Organization’s email RETREAT@BORNANDRAISEDAU.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/4/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A25 - Arts Education
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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 RACHEL BARISH
Signature Title PRESIDENT
Signature Date 6/4/19

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