FORM 1023-EZ for TRIPLE NICKEL INC

Field Data
EIN 81-4944252
Case Number EO-2018012-000311
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRIPLE NICKEL INC
Organization’s Mailing Address 2719 N VALLE VERDE DR
City NOGALES
State AZ
ZIP 85621
Accounting period End 12
Primary contact name DAVID BARRAZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE MAYER
PRESIDENT
2719 N VALLE VERDE DR
NOGALES AZ 85621

Officer/Director/Trustee Two

RENE MARTINEZ
VICE-PRESIDENT
2525 N PROTO DRI
NOGALES AZ 85621

Officer/Director/Trustee Three

DAVID BARRAZA
TREASURER
315 E CALLE GUADALUPE
NOGALES AZ 85621

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/19/16
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O41 - Boy Scouts of America
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 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 DAVID BARRAZA
Signature Title TREASURER
Signature Date 1/10/18

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