FORM 1023-EZ for BRANDON CHAMPION FOUNDATION

Field Data
EIN 86-2246617
Case Number EO-2021097-001061
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRANDON CHAMPION FOUNDATION
Organization’s Mailing Address 3360 COFFEY LANE STE B
City SANTA ROSA
State CA
ZIP 95403
Accounting period End 12
Primary contact name DARYL REESE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JILL CHAMPION
DIRECTOR PRESIDENT
3360 COFFEY LANE STE B
SANTA ROSA CA 95403

Officer/Director/Trustee Two

RONALD CHAMPION
DIRECTOR
3360 COFFEY LANE STE B
SANTA ROSA CA 95403

Officer/Director/Trustee Three

CAMERON BELVEDERE
DIRECTOR-TREASURER
3360 COFFEY LANE STE B
SANTA ROSA CA 95403

Officer/Director/Trustee Four

GIOVANNI BALISTRERI
DIRECTOR-SECRETARY
3360 COFFEY LANE STE B
SANTA ROSA CA 95403

Officer/Director/Trustee Five

JOHN MARICICH
DIRECTOR- VICE PRESIDENT
3360 COFFEY LANE STE B
SANTA ROSA CA 95403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/5/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 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 JILL CHAMPION
Signature Title DIRECTOR PRESIDENT
Signature Date 3/17/2021

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