FORM 1023-EZ for BLUE MOUNTAIN WRESTLING BOOSTERS CLUB

Field Data
EIN 82-1765931
Case Number EO-2017160-000234
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE MOUNTAIN WRESTLING BOOSTERS CLUB
Organization’s Mailing Address 129 COLD RUN ROAD
City NEW RINGGOLD
State PA
ZIP 17960
Accounting period End 12
Primary contact name DAVID MASON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROB OAKLEY
PRESIDENT
69 KELSEY DRIVE
SCHUYLKILL HAVEN PA 17972

Officer/Director/Trustee Two

DAVID MASON
TREASURER
129 COLD RUN ROAD
NEW RINGGOLD PA 17960

Officer/Director/Trustee Three

JODY STEIN
SECRETARY
449 BLUE MOUNTAIN ROAD
SCHUYLKILL HAVEN PA 17972

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2008
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - 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 No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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