FORM 1023-EZ for BLACK RIVER OFF-ROADERS

Field Data
EIN 83-4091285
Case Number EO-2019170-000132
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK RIVER OFF-ROADERS
Organization’s Mailing Address PO BOX 136
City LESTERVILLE
State MO
ZIP 63654
Accounting period End 12
Primary contact name NICHOLAS MAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICHOLAS MAYES
PRESIDENT
525 COUNTY ROAD 816
BLACK MO 63625

Officer/Director/Trustee Two

AARON MAIZE
VICE PRESIDENT
2144 E HIGHWAY 72
FREDERICKTOWN MO 63645

Officer/Director/Trustee Three

STACEY FREEMAN
TREASURE
20918 HIGHWAY 49
BLACK MO 63625

Officer/Director/Trustee Four

KRIS PARKER
SECRETARY
31996 HIGHWAY 21
LESTERVILLE MO 63654

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/17/19
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 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 NICHOLAS MAYES
Signature Title PRESIDENT
Signature Date 6/17/19

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