FORM 1023-EZ for BLOOMINGTON ULTIMATE INCORPORATED

Field Data
EIN 27-4281901
Case Number EO-2018053-000158
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOOMINGTON ULTIMATE INCORPORATED
Organization’s Mailing Address 5400 NORTH BRUMMETTS CREEK RD
City BLOOMINGTON
State IN
ZIP 47408
Accounting period End 12
Primary contact name MARY UTHUPPURU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY UTHUPPURU
PRESIDENT
5400 NORTH BRUMMETTS CREEK RD
BLOOMINGTON IN 47408

Officer/Director/Trustee Two

JAMES QUILL
VICE PRESIDENT
1301 S LINCOLN ST
BLOOMINGTON IN 47401

Officer/Director/Trustee Three

SEAN KRIESBERG
SECRETARY AND TREASURER
1752 W SUNSTONE DR
BLOOMINGTON IN 47403

Organization’s website WWW.BLOOMINGTONULTIMATE.ORG
Organization’s email ULTIMATE.BLOOMINGTON@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/17
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 MARY UTHUPPURU
Signature Title PRESIDENT
Signature Date 2/20/18

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