FORM 1023-EZ for BLACK COAL & ROSES SOCIETY INC

Field Data
EIN 87-2531059
Case Number EO-2021253-000227
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK COAL & ROSES SOCIETY INC
Organization’s Mailing Address 214 WINDMERE DRIVE
City PADUCAH
State KY
ZIP 42001
Accounting period End 12
Primary contact name SHONDA HOLLOWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHONDA HOLLOWELL
DIRECTOR
214 WINDMERE DRIVE
PADUCAH KY 42001

Officer/Director/Trustee Two

DAVID WADE
OFFICER
816 HC MATHIS DRIVE
PADUCAH KY 42003

Officer/Director/Trustee Three

RAIONA HENDERSON
OFFICER
650 NORTH 24TH STREET
PADUCAH KY 42003

Organization’s website WWW.BCRSMENTORING.COM
Organization’s email BCRSMENTORING@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/2021
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 SHONDA HOLLOWELL
Signature Title DIRECTOR
Signature Date 9/8/2021

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