FORM 1023-EZ for BLACK DIAMOND BEE RESCUE

Field Data
EIN 86-3456234
Case Number EO-2021245-000391
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK DIAMOND BEE RESCUE
Organization’s Mailing Address 509 BLACK DIAMOND RD
City PORT ANGELES
State WA
ZIP 98363
Accounting period End 3
Primary contact name GUS GUSTAFSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GUS GUSTAFSON
PRESIDENT
509 BLACK DIAMOND RD
PORT ANGELES WA 98363

Officer/Director/Trustee Two

AUTUMN GUSTAFSON
VICE PRESIDENT
507 BLACK DIAMOND RD
PORT ANGELES WA 98363

Officer/Director/Trustee Three

RACHELLE MCGIMPSEY
SECRETARY TRESURER
509 BLACK DIAMOND RD
PORT ANGELE WA 98363

Organization’s website
Organization’s email GUSSER@YMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/2021
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C99 - Environmental Quality, Protection, and Beautification N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 GUS GUSTAFSON
Signature Title PRESIDENT
Signature Date 8/31/2021

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