FORM 1023-EZ for CLUB BLUE A NJ NONPROFIT CORPORATION

Field Data
EIN 46-4008828
Case Number EO-2017093-000478
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLUB BLUE A NJ NONPROFIT CORPORATION
Organization’s Mailing Address 841 SOUTH 11TH STREET
City NEWARK
State NJ
ZIP 07108
Accounting period End 12
Primary contact name ISIS RIVERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ISIS RIVERS
TRUSTEE
841 SOUTH 11TH STREET
NEWARK NJ 07108

Officer/Director/Trustee Two

MAKEBA GREEN
TRUSTEE
841 SOUTH 11TH STREET
NEWARK NJ 07108

Officer/Director/Trustee Three

PAT GREEN
TRUSTEE
841 SOUTH 11TH STREET
NEWARK NJ 07108

Organization’s website
Organization’s email ISISRIVERS2013@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/2013
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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
Signature Title
Signature Date

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