FORM 1023-EZ for BALLERS FOR JESUS

Field Data
EIN 82-3194494
Case Number EO-2018198-000094
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BALLERS FOR JESUS
Organization’s Mailing Address 4716 WHISPERING WIND AVE
City TAMPA
State FL
ZIP 33614
Accounting period End 10
Primary contact name ROBIN DICKEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBIN DICKEY
DIRECTOR
4716 WHISPERING WIND AVE
TAMPA FL 33614

Officer/Director/Trustee Two

SAMUEL DIAZ
OFFICER
30411 ANNADALE DR
WESLEY CHAPEL FL 33545

Officer/Director/Trustee Three

ANTWAIN DAVIS
OFFICER
3450 PALENCIA DR 1615
TAMPA FL 33618

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROBIN DICKEY
Signature Title DIRECTOR
Signature Date 7/13/18

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