FORM 1023-EZ for BLUE SHAMROCK SOCIETY INC

Field Data
EIN 84-1748313
Case Number EO-2019177-000309
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE SHAMROCK SOCIETY INC
Organization’s Mailing Address 1624 BEECHWOOD TERRACE
City MANHATTAN
State KS
ZIP 66502
Accounting period End 12
Primary contact name TIMOTHY FITZGERALD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIMOTHY FITZGERALD
PRESIDENT
1624 BEECHWOOD TER
MANHATTAN KS 66502

Officer/Director/Trustee Two

REBECCA FITZGERALD
VICE-PRESIDENT/SECRETARY
1624 BEECHWOOD TER
MANHATTAN KS 66502

Officer/Director/Trustee Three

AMY FITZGERALD
DIRECTOR/MEDICAL OUTREACH
412 W LINDSBORG STREET
LINDSBORG KS 67456-2716

Officer/Director/Trustee Four

BRAD HOGGATT
TREASURER
6692 FONDER DRIVE
PARKER CO 80134

Officer/Director/Trustee Five

SHANNON HOGGATT
DIRECTOR/PUBLIC OUTREACH
6692 FONDER DRIVE
PARKER CO 80134

Organization’s website BLUESHAMROCK.ORG
Organization’s email BLUESHAMROCKSOCIETY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/14/19
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TIMOTHY FITZGERALD
Signature Title PRESIDENT
Signature Date 6/24/19

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