FORM 1023-EZ for ROD GUN SAFETY AND EDUCATION

Field Data
EIN 80-0690970
Case Number EO-2015124-000120
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROD GUN SAFETY AND EDUCATION
Organization’s Mailing Address 3334 BROOKSHILL RD PO BOX 151
City LANGLEY
State WA
ZIP 98260
Accounting period End 12
Primary contact name ILENE MAGNUSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MIKE MCINERNEY
PRESIDENT
4848 PINEWOOD CIRCLE
LANGLEY WA 98260

Officer/Director/Trustee Two

ROBERT BLASKO
VICE PRESIDENT
3378 BURLEY RD
CLINTON WA 98236

Officer/Director/Trustee Three

JACK HEALY
SECRETARY
PO BOX 1030
LANGLEY WA 98260

Officer/Director/Trustee Four

DAVE SHUPE
TREASURER
6729 VIEWMONT DR
CLINTON WA 98236

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2011
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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