FORM 1023-EZ for BLUE WHITE AND GOLD INC

Field Data
EIN 47-3601886
Case Number EO-2015126-000301
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE WHITE AND GOLD INC
Organization’s Mailing Address 2789 NE 5TH ST
City POMPANO BEACH
State FL
ZIP 33062-4924
Accounting period End 12
Primary contact name SIMON PACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SIMON PACK
PRESIDENT AND DIRECTOR
2789 NE 5th St
POMPANO BEACH FL 33062-4924

Officer/Director/Trustee Two

ALEXANDRA SHKLAR
VICE-PRESIDENT AND DIRECTOR
2789 NE 5TH ST
POMPANO BEACH FL 33062-4924

Officer/Director/Trustee Three

SHARON COHEN
SECRETARY AND DIRECTOR
2789 NE 5th St
POMPANO BEACH FL 33062-4924

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 Yes
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
Signature Title
Signature Date

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