FORM 1023-EZ for HUNTINGTON JUNIOR ROLLER DERBY LEAGUE INC

Field Data
EIN 81-2843721
Case Number EO-2019137-000315
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HUNTINGTON JUNIOR ROLLER DERBY LEAGUE INC
Organization’s Mailing Address 618 JEFFERSON AVENUE
City HUNTINGTON
State WV
ZIP 25704
Accounting period End 12
Primary contact name DAVID DICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID DICK
TREASURER
618 JEFFERSON AVENUE
HUNTINGTON WV 25704

Officer/Director/Trustee Two

KELLY DICK
SECRETARY
618 JEFFERSON AVENUE
HUNTINGTON WV 25704

Officer/Director/Trustee Three

SAMANTHA CHAPMAN
PRESIDENT
1721 COUNTY ROAD 104
CHESAPEAKE OH 45619

Organization’s website
Organization’s email HJRDLSK8@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/19
Organization Incorporation State WV
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: Yes
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 DAVID DICK
Signature Title TREASURER
Signature Date 5/15/19

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