FORM 1023-EZ for BASILISK FC

Field Data
EIN 30-0829864
Case Number EO-2014303-000071
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BASILISK FC
Organization’s Mailing Address 1716 L STREET
City SACRAMENTO
State CA
ZIP 95811-4024
Accounting period End 12
Primary contact name K GREG PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES THOMAS
CHIEF EXECUTIVE OFFICER
1250 CHARITY LANE
DIXON CA 95620-2138

Officer/Director/Trustee Two

K GREG PETERSON
TREASURER
1716 L STREET
SACRAMENTO CA 95814

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M20 - Disaster Preparedness and Relief Services
Organization’s purpose Charitable: No
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 Yes
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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