FORM 1023-EZ for GOLDEN STATE ROLLER DERBY

Field Data
EIN 83-3599185
Case Number EO-2019092-000495
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOLDEN STATE ROLLER DERBY
Organization’s Mailing Address 415 MING AVE
City BAKERSFIELD
State CA
ZIP 93307
Accounting period End 12
Primary contact name WHITNEY G PLUMMER III
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVEN CURTIS
PRESIDENT
11616 MINDANAO ST
CYPRESS CA 90630

Officer/Director/Trustee Two

VICTOR SWALL
VICE PRESIDENT
2408 MOFFITT WAY
BAKERSFIELD CA 93309

Officer/Director/Trustee Three

RICHARD SAN AGUSTIN
TREASURER
11107 ARMINTA ST APT 13
SUN VALLEY CA 91352

Officer/Director/Trustee Four

WHITNEY PLUMMER III
SECRETARY
5719 ALDAMA ST
LOS ANGELES CA 90042

Organization’s website
Organization’s email GOLDENSTATEHEAT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/4/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name WHITNEY PLUMMER III
Signature Title SECRETARY
Signature Date 3/31/19

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