FORM 1023-EZ for RISE OF THE PHOENIX

Field Data
EIN 84-3658171
Case Number EO-2019322-000433
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RISE OF THE PHOENIX
Organization’s Mailing Address 11 ALASKA ROAD
City RIVERTON
State WY
ZIP 82501
Accounting period End 12
Primary contact name VALERIE LESEBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VALERIE LESEBERG
SECRETARY/TREASURER
11 ALASKA ROAD
RIVERTON WY 82501

Officer/Director/Trustee Two

SAMMI BUZZARD
PRESIDENT
81 SHADY LANE
PAVILLION WY 82523

Officer/Director/Trustee Three

JUSTIN HEGWER
VIC PRESIDENT
81 SHADY LANE
PAVILLION WY 82523

Organization’s website
Organization’s email VAL@RISEOFTHEPHOENIXWY.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/19
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
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 Yes
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 VALERIE LESEBERG
Signature Title SECRETARY/TREASURER
Signature Date 11/15/19

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