FORM 1023-EZ for REVERT FOUNDATION INC

Field Data
EIN 47-5372353
Case Number EO-2016033-000246
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REVERT FOUNDATION INC
Organization’s Mailing Address PO BOX 332
City GRASS VALLEY
State CA
ZIP 95945-0332
Accounting period End 9
Primary contact name IRA HECHT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRIS ROACH
PRESIDENT/DIRECTOR
PO BOX 332
GRASS VALLEY CA 95945-0332

Officer/Director/Trustee Two

DEVIN RYERSON
SECRETARY/TREASURER/DIRECTOR
5670 EL CAMINO REAL SUITE D
CARLSBAD CA 92008-7125

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/21/2015
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
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 Yes
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 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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