FORM 1023-EZ for BLACK DRAGON KARATE INC

Field Data
EIN 47-4687802
Case Number EO-2015254-000320
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK DRAGON KARATE INC
Organization’s Mailing Address 1221 DIVISION ST
City SULPHUR
State OK
ZIP 73086
Accounting period End 12
Primary contact name DONALD BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONALD L BLACK
PRESIDENT
49956 E CR 1570
STRATFORD OK 74872

Officer/Director/Trustee Two

DON MC KAIN
TREASURER
22 W TULSA AVE
SULPHUR OK 73086

Officer/Director/Trustee Three

ELAINE GUILLOZ
SECRETARY
1133 W 1 ST
SULPHUR OK 73086

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2015
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
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
Signature Title
Signature Date

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