FORM 1023-EZ for USA EXPLOSION EASTERN IDAHO INC

Field Data
EIN 84-2930304
Case Number EO-2019262-000103
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name USA EXPLOSION EASTERN IDAHO INC
Organization’s Mailing Address 616 BERGESON DR
City BLACKFOOT
State ID
ZIP 83221
Accounting period End 12
Primary contact name NICK STALEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICK STALEY
DIRECTOR
616 BERGESON DR
BLACKFOOT ID 83221

Officer/Director/Trustee Two

CAMERON CRONQUIST
DIRECTOR
534 W RIVERTON RD
BLACKFOOT ID 83221

Officer/Director/Trustee Three

BRANDON LARSEN
DIRECTOR
1160 E LOWER ROCK CREEK RD
INKOM ID 83245

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/28/19
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
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 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 NICK STALEY
Signature Title DIRECTOR
Signature Date 9/17/19

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