FORM 1023-EZ for BREAK THE ROCK ACADEMY

Field Data
EIN 87-1725914
Case Number EO-2021238-000179
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREAK THE ROCK ACADEMY
Organization’s Mailing Address 246 SOUTH CASSADY AVENUE
City COLUMBUS
State OH
ZIP 43209
Accounting period End 7
Primary contact name TODD WORLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TODD WORLY
PRESIDENT
246 SOUTH CASSADY AVENUE
COLUMBUS OH 43209

Officer/Director/Trustee Two

MINDY WORLY
SECRETARY
1920 WOODLANDS PLACE
POWELL OH 43065

Officer/Director/Trustee Three

DON WORLY
VICE PRESIDENT
1920 WOODLANDS PLACE
POWELL OH 43065

Organization’s website
Organization’s email TWORLY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2021
Organization Incorporation State OH
Contains Limitation No
Does not expressly empower No
Contains dissolution No
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption Yes
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 No
Signature Name TODD WORLY
Signature Title PRESIDENT
Signature Date 8/24/2021

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