FORM 1023-EZ for BLAZE INTERNATIONAL INC

Field Data
EIN 83-1038292
Case Number EO-2018337-000083
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLAZE INTERNATIONAL INC
Organization’s Mailing Address 312 CABINWOOD TRL
City CANTON
State GA
ZIP 30115
Accounting period End 12
Primary contact name KELLY DAVIDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY DAVIDSON
PRESIDENT, DIRECTOR
312 CABINWOOD TRL
CANTON GA 30115

Officer/Director/Trustee Two

JOSE MALDONADO
SECRETARY, DIRECTOR
3014 CREEKSIDE VLG DR STE 303
KENNESAW GA 30144

Officer/Director/Trustee Three

CHRIS TUTTLE
TREASURER, DIRECTOR
329 LADY SLIPPER LN
WOODSTOCK GA 30188

Officer/Director/Trustee Four

CRAIG TUCK
DIRECTOR
199 REVETMENT LN
MOUNT PLEASANT SC 29464

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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 KELLY DAVIDSON
Signature Title PRESIDENT, DIRECTOR
Signature Date 11/29/18

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