FORM 1023-EZ for OLIVE BRANCH LODGE NUMBER 93 INC

Field Data
EIN 82-5113400
Case Number EO-2019298-000274
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OLIVE BRANCH LODGE NUMBER 93 INC
Organization’s Mailing Address 24448 PINETOWN ROAD
City PRESTON
State MD
ZIP 21655
Accounting period End 12
Primary contact name DERICK BRUMMELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM RICKETTS
PRESIDENT
22378 SHORE HIGHWAY
DENTON MD 21629

Officer/Director/Trustee Two

KEN BAILEY
VICE PRESIDENT
223 DENTON ROAD
FREDERALSBURG MD 21632

Officer/Director/Trustee Three

DERICK BRUMMELL
SECRETARY
24448 PINETOWN ROAD
PRESTON MD 21655

Officer/Director/Trustee Four

CHARLES PRATTIS
TREASURER
P O BOX 271
DENTON MD 21629

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/19
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DERICK BRUMMELL
Signature Title SECRETARY
Signature Date 10/23/19

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