FORM 1023-EZ for BICYCLE HELMET SAFETY INSTITUTE

Field Data
EIN 81-4084438
Case Number EO-2016287-000115
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BICYCLE HELMET SAFETY INSTITUTE
Organization’s Mailing Address 4611 7TH ST S
City ARLINGTON
State VA
ZIP 22204-1419
Accounting period End 10
Primary contact name RANDOLPH SWART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDOLPH SWART
DIRECTOR
4611 7TH ST S
ARLINGTON VA 22204-1419

Organization’s website HELMETS.ORG
Organization’s email INFO@HELMETS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/5/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M40 - Safety Education
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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 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
Signature Title
Signature Date

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