FORM 1023-EZ for JAM BLUE RIDGE INC

Field Data
EIN 84-4721133
Case Number EO-2020050-000309
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JAM BLUE RIDGE INC
Organization’s Mailing Address 1485 TWIN LAKES DRIVE
City HIGHLANDS
State NC
ZIP 28741
Accounting period End 12
Primary contact name DEBBIE LASSITER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOB MERRIMAN
DIRECTOR
11 BOWSPRIT LANE
SALEM SC 29676

Officer/Director/Trustee Two

DEBBIE LASSITER
DIRECTOR
1485 TWIN LAKES DRIVE
HIGHLANDS NC 28741

Officer/Director/Trustee Three

JANE DAVIS
DIRECTOR
221 PANTHERTOWN TRAIL UNIT 2119
SAPPHIRE NC 28774

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A25 - Arts Education
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 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 BOB MERRIMAN
Signature Title DIRECTOR
Signature Date 2/17/2020

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