FORM 1023-EZ for BLUE BACKYARD INC

Field Data
EIN 81-5449197
Case Number EO-2017067-000352
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE BACKYARD INC
Organization’s Mailing Address 3373 CHARLES AVE
City MIAMI
State FL
ZIP 33131
Accounting period End 12
Primary contact name JESSICA SHRAYBMAN ATTORNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TASHANA TAYLOR
DIRECTOR
3927 SW 64 AVE
MIAMI FL 33155

Officer/Director/Trustee Two

KARLISA CALLWOOD
DIRECTOR
130 JOHNSON AVE
PORT TOWNSEND WA 98368

Officer/Director/Trustee Three

ANDREW PEARCE CARTER
DIRECTOR
1150 EUCLID AVE APT 301
MIAMI BEACH FL 33139

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C60 - Environmental Education and Outdoor Survival Programs
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
Signature Title
Signature Date

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