FORM 1023-EZ for BLACK ROCK PROJECT INC

Field Data
EIN 82-1383170
Case Number EO-2017164-000194
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK ROCK PROJECT INC
Organization’s Mailing Address 6608 N WESTERN AVENUE SUITE 623
City OKLAHOMA CITY
State OK
ZIP 73116
Accounting period End 12
Primary contact name SHERRY DALE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIFFANY GWYNN
PRESIDENT
625 NW 143RD STREET
EDMOND OK 73013

Officer/Director/Trustee Two

VALERIE HALLAM
SECRETARY
1110 NW 55TH STREET
OKLAHOMA CITY OK 73118

Officer/Director/Trustee Three

CHELSEA WHITE
TREASURER
2922 NW 21ST STREET
OKLAHOMA CITY OK 73107

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/2017
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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
Signature Title
Signature Date

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