FORM 1023-EZ for MICRO BOOM ACADEMY

Field Data
EIN 82-4467989
Case Number EO-2018078-000569
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MICRO BOOM ACADEMY
Organization’s Mailing Address 2957 GLEN ALBYN DR
City SANTA BARBARA
State CA
ZIP 93105-2219
Accounting period End 12
Primary contact name IVAN PELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IVAN PELLY
CEO
2957 GLEN ALBYN DR
SANTA BARBARA CA 93105

Officer/Director/Trustee Two

ASHTON PELLY
SECRETARY
2957 GLEN ALBYN DR
SANTA BARBARA CA 93105

Officer/Director/Trustee Three

TERRY TYLER
TREASURER
12 AUGUSTA LN
SANTA BARBARA CA 93108

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name IVAN PELLY
Signature Title CEO
Signature Date 3/17/18

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