FORM 1023-EZ for GRANITE BAY JIU-JITSU ACADEMY

Field Data
EIN 83-3635273
Case Number EO-2019053-000089
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRANITE BAY JIU-JITSU ACADEMY
Organization’s Mailing Address 4120 DOUGLAS BLVD STE 309
City GRANITE BAY
State CA
ZIP 95746
Accounting period End 12
Primary contact name RYAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RYAN RICH
CEO
4120 DOUGLAS BLVD STE 309
GRANITE BAY CA 95746

Officer/Director/Trustee Two

CHRISTINE ZELNIK
CFO
4120 DOUGLAS BLVD STE 309
GRANITE BAY CA 95746

Officer/Director/Trustee Three

BRYAN MERICA
SECRETARY
555 CAPITOL MALL 640
SACRAMENTO CA 95814

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 RYAN RICH
Signature Title CEO
Signature Date 2/19/19

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