FORM 1023-EZ for SILVER BRIDGE BRUISERS ROLLER DERBYLEAGUE

Field Data
EIN 47-4883707
Case Number EO-2015245-000318
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SILVER BRIDGE BRUISERS ROLLER DERBYLEAGUE
Organization’s Mailing Address 412 HONEYSUCKLE DR
City CHESHIRE
State OH
ZIP 45620
Accounting period End 12
Primary contact name HEATHER BLAZER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HEATHER BLAZER
PRESIDENT
412 HONEYSUCKLE DR
CHESHIRE OH 45620

Officer/Director/Trustee Two

BRANDEE SCHUHL
VICE PRESIDENT
787 HONEYSUCKLE DR
CHESHIRE OH 45620

Officer/Director/Trustee Three

JULIE JARRELL
SECRETARY
1320 WHEATON RD
BIDWELL OH 45614

Officer/Director/Trustee Four

ANGELA GUINTHER
TREASURER
49 SANDERS DR
GALLIPOLIS OH 45631

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2015
Organization Incorporation State OH
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: Yes
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 Yes
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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