FORM 1023-EZ for BLOCKCHAIN INNOVATION SOCIETY

Field Data
EIN 83-0527647
Case Number EO-2018136-000587
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOCKCHAIN INNOVATION SOCIETY
Organization’s Mailing Address 111 E TAYLOR ST SUITE 120 MC8520
City PHOENIX
State AZ
ZIP 85004
Accounting period End 12
Primary contact name JEREMY LIU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEREMY LIU
DIRECTOR
111 E TAYLOR ST SUITE 120
PHOENIX AZ 85004

Officer/Director/Trustee Two

MARCUS JONES
DIRECTOR
111 E TAYLOR ST SUITE 120
PHOENIX AZ 85004

Organization’s website WWW.INNOVATEBLOCKCHAIN.ORG
Organization’s email ADMIN@INNOVATEBLOCKCHAIN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
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 JEREMY LIU
Signature Title DIRECTOR
Signature Date 5/14/18

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