FORM 1023-EZ for BLAIR WRESTLING CLUB

Field Data
EIN 81-2999754
Case Number EO-2016287-000045
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLAIR WRESTLING CLUB
Organization’s Mailing Address 440 N 10TH ST
City BLAIR
State NE
ZIP 68008
Accounting period End 12
Primary contact name RACHEL A TRUHLSEN ATTORNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC DOLEZAL
PRESIDENT
10267 HUNTINGTON AVE
OMAHA NE 68122

Officer/Director/Trustee Two

TREVOR TEMPLAR
VICE PRESIDENT
1115 N 28TH ST
BLAIR NE 68008

Officer/Director/Trustee Three

TERRY BELLAMY
TREASURER
15718 CO RD 21
BLAIR NE 68008

Officer/Director/Trustee Four

JULIE FROST
SECRETARY
12388 CO RD 25
BLAIR NE 68008

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2016
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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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