FORM 1023-EZ for PRISON CITY ROLLER DERBY

Field Data
EIN 84-3032885
Case Number EO-2020297-000387
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PRISON CITY ROLLER DERBY
Organization’s Mailing Address 14071 PEYTON DR UNIT 31
City CHINO HILLS
State CA
ZIP 91709
Accounting period End 12
Primary contact name VIVIENNE LEONANO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE GARCIA
PRESIDENT
1268 BONNIE BRAE ST
POMONA CA 91767

Officer/Director/Trustee Two

KATHRYN GARCIA
VICE PRESIDENT
649 ELM ST
PNTARIO CA 91761

Officer/Director/Trustee Three

CLAUDIA PENA
SECRETARY
1605 JESS ST
POMONA CA 91766

Officer/Director/Trustee Four

VIVIENNE LEONANO
TREASURER
2757 E LA AVENIDA DR
ONTARIO CA 91761

Officer/Director/Trustee Five

ROBYN BREWER
DIRECTOR OF MARKETING
3461 LEGATO CT
POMONA CA 91766

Organization’s website https://prisoncityrollerddrby.com/
Organization’s email prisoncityrollerderby@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2019
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: No
Religious: No
Educational: No
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 VIVIENNE LEONANO
Signature Title TREASURER
Signature Date 10/20/2020

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