FORM 1023-EZ for POLICE BLUE NATION INC

Field Data
EIN 81-3710050
Case Number EO-2016294-000135
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POLICE BLUE NATION INC
Organization’s Mailing Address PO BOX 149
City HARTFORD
State CT
ZIP 06101
Accounting period End 12
Primary contact name LEO CHUPRON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEO CHUPRON
DIRECTOR
291 BLUE HILLS DRIVE
SOUTHINGTON CT 06489

Officer/Director/Trustee Two

J BRUCE CARRIER
DIRECTOR
346 TOWN HALL ROAD
NEW HARTFORD CT 06053

Officer/Director/Trustee Three

ERIK DUENAS
DIRECTOR
74 LISA LANE
MIDDLETOWN CT 06457

Officer/Director/Trustee Four

JEREMY POWELL
DIRECTOR
119 HOFFMAN ROAD
ELLINGTON CT 06029

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2016
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I12 - 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 Yes
Donation of funds Yes
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
Signature Title
Signature Date

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