FORM 1023-EZ for GRASSROOTS RUNNING CLUB INC

Field Data
EIN 83-0986833
Case Number EO-2018176-000381
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRASSROOTS RUNNING CLUB INC
Organization’s Mailing Address 3121 ALTHORP WAY
City LEXINGTON
State KY
ZIP 40509
Accounting period End 12
Primary contact name LINDSEY ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDSEY ROBERTS
PRESIDENT
3121 ALTHORP WAY
LEXINGTON KY 40509

Officer/Director/Trustee Two

SHELLEY ROBERTS
VICE PRESIDENT
3121 ALTHORP WAY
LEXINGTON KY 40509

Officer/Director/Trustee Three

JODIE MORAN
TREASURER
3170 MAPLELEAF DR APT 909
LEXINGTON KY 40509

Officer/Director/Trustee Four

LEAH PARK
SECRETARY
1597 N CLEVELAND RD
LEXINGTON KY 40509

Officer/Director/Trustee Five

RICK INGRAM
BOARD DIRECTOR
1129 CHETFORD DR
LEXINGTON KY 40509

Organization’s website
Organization’s email GRASSROOTSRX@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/18
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics 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 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 LINDSEY ROBERTS
Signature Title PRESIDENT
Signature Date 6/22/18

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