FORM 1023-EZ for TROOPER BLACK FOUNDATION

Field Data
EIN 84-2953745
Case Number EO-2019252-000253
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TROOPER BLACK FOUNDATION
Organization’s Mailing Address 2 ANDREWS WAY
City YORK
State ME
ZIP 3909
Accounting period End 12
Primary contact name CHARLES C BLACK II
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES BLACK
DIRECTOR
2 ANDREW
YORK ME 3909

Officer/Director/Trustee Two

MARY BLACK ANDREWS
DIRECTOR
121 OLD POST ROAD
YORK ME 3909

Officer/Director/Trustee Three

OWEN DAVIS
DIRECTOR
34 SCITUATE ROAD
YORK ME 3909

Officer/Director/Trustee Four

GREGORY ORSO
DIRECTOR
6 CIDER SPRING LANE
YORK ME 3909

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/19
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 Yes
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 CHARLES BLACK
Signature Title DIRECTOR
Signature Date 9/5/19

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