FORM 1023-EZ for INDIANA BLAZE ORGANIZATION

Field Data
EIN 47-4723056
Case Number EO-2015225-000293
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INDIANA BLAZE ORGANIZATION
Organization’s Mailing Address 12887 END ZONE DRIVE
City HAMILTON
State IN
ZIP 46037
Accounting period End 12
Primary contact name KENNETH LAMPLEY II
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KENNETH LAMPLEY II
PRESIDENT
12887 END ZONE DRIVE
FISHERS IN 46037

Officer/Director/Trustee Two

JANNON LAMPLEY
TREASURER
12887 END ZONE DRIVE
FISHERS IN 46037

Officer/Director/Trustee Three

AKEEM CLARK
SECRETARY
1809 SHOSHONE DRIVE / APT 33
LAFAYETTE IN 47909

Officer/Director/Trustee Four

BILL MOSS
DIRECTOR
303 THOMPSON STREET
URBANA OH 43078

Officer/Director/Trustee Five

LONNIE RANDOLPH III
DIRECTOR
4437 ALDER STREET
EAST CHICAGO IN 46312

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2012
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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