FORM 1023-EZ for A TRIBE FOR JAZZ

Field Data
EIN 86-3671102
Case Number EO-2021224-000152
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A TRIBE FOR JAZZ
Organization’s Mailing Address 3000B EAST MAIN STREET NO 280
City COLUMBUS
State OH
ZIP 43209
Accounting period End 12
Primary contact name BRUCE HALLIBURTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE MATTHEWS
EXEC DIRECTOR& PRESIDENT
97 BRUNSON AVE
COLUMBUS OH 43203

Officer/Director/Trustee Two

LINA GRAJEWSKI
TREASURER & DIRECTOR
77 SOUTHWOOD AVE
COLUMBUS OH 43207

Officer/Director/Trustee Three

TIM LOCKARD
SECRETARY & DIRECTOR
205 S HIGH STREET NO 119
COLUMBUS OH 43215

Officer/Director/Trustee Four

JOHN BEYER
DIRECTOR
555 FILMORE AVE
EAST AURORA NY 14052

Officer/Director/Trustee Five

BRUCE HALLIBURTON
DIRECTOR
3000B EAST MAIN ST NO 280
COLUMBUS OH 43209

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2021
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 Yes
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 BRUCE HALLIBURTON
Signature Title DIRECTOR
Signature Date 8/10/2021

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