FORM 1023-EZ for MIDNIGHT JIU-JITSU CLUB

Field Data
EIN 85-2751190
Case Number EO-2020274-000337
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIDNIGHT JIU-JITSU CLUB
Organization’s Mailing Address 755 BELLEVUE AVE E
City SEATTLE
State WA
ZIP 98102
Accounting period End 12
Primary contact name THOM DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DMITRIY GAK
EXECUTIVE DIRECTOR/PRESIDENT
755 BELLEVUE AVE E
SEATTLE WA 98102

Officer/Director/Trustee Two

GAVIN COCHRAN
FINANCIAL CONTROLLER/TREASURER/DIR
755 BELLEVUE AVE E
SEATTLE WA 98102

Officer/Director/Trustee Three

THOM DIXON
HEAD OF CURRICULUM/SEC/DIR
1711 E OLIVE WAY APT 119
SEATTLE WA 98102

Officer/Director/Trustee Four

DANIEL GONZALEZ
HEAD OF MARKETING/DIRECTOR
755 BELLEVUE AVE E
SEATTLE WA 98102

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/2020
Organization Incorporation State WA
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: 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name THOM DIXON
Signature Title HEAD OF CURRICULUM/SEC/DIR
Signature Date 9/28/2020

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