FORM 1023-EZ for BLAZER BOLT INC

Field Data
EIN 47-4030497
Case Number EO-2015142-000428
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLAZER BOLT INC
Organization’s Mailing Address 510 20TH STREET SOUTH FOT 1020
City BIRMINGHAM
State AL
ZIP 35294
Accounting period End 12
Primary contact name DR LB NABORS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RHODEMARIE MARON
DIRECTOR AND PRESIDENT
1820 OXMOOR ROAD 313
BIRMINGHAM AL 35209

Officer/Director/Trustee Two

DR L BURT NABORS
VICE-PRESIDENT AND DIRECTOR
510 20TH STREET SOUTH FOT 1020
BIRMINGHAM AL 35294

Officer/Director/Trustee Three

SHIRLEY GIBBS
DIRECTOR SECRETARY AND TREASUEER
510 20TH STREET SOUTH FOT 1020
BIRMINGHAM AL 35294

Officer/Director/Trustee Four

JERI HASLEM
DIRECTOR
1593 DEER VALLEY DRIVE
HOOVER AL 35226

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2015
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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
Signature Title
Signature Date

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