FORM 1023-EZ for DERBY WITHOUT BORDERS

Field Data
EIN 84-5008410
Case Number EO-2020199-000254
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DERBY WITHOUT BORDERS
Organization’s Mailing Address PO BOX 1328
City GUERNEVILLE
State CA
ZIP 95446
Accounting period End 12
Primary contact name MEGHAN SCHUTTLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MEGHAN SCHUTTLER
CEO, PRESIDENT AND DIRECTOR
1930 8TH AVE
OAKLAND CA 94606

Officer/Director/Trustee Two

ANDREA HORTON
SECRETARY AND DIRECTOR
PO BOX 1328
GUERNEVILLE CA 95446

Officer/Director/Trustee Three

ELKE SANDOVAL
DIRECTOR
PO BOX 666
KENWOOD CA 95452

Officer/Director/Trustee Four

APRIL FOURNIER
DIRECTOR
1241 WASHINGTON AVE
PORTLAND ME 04103

Officer/Director/Trustee Five

TESS HARRISON
DIRECTOR
2935 CEDAR CREEK PARKWAY
DECATUR GA 30033

Organization’s website HTTPS://DERBYWITHOUTBORDERS.ORG/
Organization’s email DERBYWITHOUTBORDERS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/2020
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: Yes
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 No
Conducting Activities Outside of United States Yes
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 MEGHAN SCHUTTLER
Signature Title CEO, PRESIDENT AND DIRECTOR
Signature Date 7/15/2020

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