FORM 1023-EZ for ROGUE BLADES FOUNDATION

Field Data
EIN 84-3489417
Case Number EO-2019301-000753
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROGUE BLADES FOUNDATION
Organization’s Mailing Address 409 SD 28530
City JUNCTION
State TX
ZIP 76849
Accounting period End 12
Primary contact name JASON WALTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON WALTZ
EXECUTIVE DIRECTOR
409 SD 28530
JUNCTION TX 76849

Officer/Director/Trustee Two

TAMANTHA WALTZ
DIRECTOR/SECRETARY
409 SD 28530
JUNCTION TX 76849

Officer/Director/Trustee Three

HARMON TYRONE JOHNSTON
DIRECTOR/AT LARGE
18 PARADISE COVE
TIMBERLAKE NC 27583

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A33 - Printing, Publishing
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 JASON WALTZ
Signature Title EXECUTIVE DIRECTOR
Signature Date 10/25/19

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