FORM 1023-EZ for BOURBON LANE STABLE RETIREMENT FUNDINC

Field Data
EIN 84-2215966
Case Number EO-2019217-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BOURBON LANE STABLE RETIREMENT FUNDINC
Organization’s Mailing Address PO BOX 4543
City MIDWAY
State KY
ZIP 40347
Accounting period End 12
Primary contact name HARVEY THOMPSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES HILL V
PRESIDENT & DIRECTOR
119 E MAIN STREET
MIDWAY KY 40347

Officer/Director/Trustee Two

MICHAEL MCMAHON
TREASURER & DIRECTOR
119 E MAIN STREET
MIDWAY KY 40347

Officer/Director/Trustee Three

NICHOLAS LOIACONO
VICE PRESIDENT & DIRECTOR
119 E MAIN STREET
MIDWAY KY 40347

Officer/Director/Trustee Four

VALERIE CALCOTT STEVENS
RECORDING OFFICER & DIRECTOR
119 E MAIN STREET
MIDWAY KY 40347

Officer/Director/Trustee Five

MAGGIE OBRYAN SEIDMAN
DIRECTOR
119 E MAIN STREET
MIDWAY KY 40347

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/25/19
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 JAMES HILL V
Signature Title PRESIDENT & DIRECTOR
Signature Date 8/1/19

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