FORM 1023-EZ for ADOPT A COP BJJ INC

Field Data
EIN 85-3367678
Case Number EO-2020287-000295
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADOPT A COP BJJ INC
Organization’s Mailing Address 200 TINTERN CT STE 111
City CHESAPEAKE
State VA
ZIP 23320
Accounting period End 12
Primary contact name DIRK SAMPSELLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MITCHELL AGUIAR
PRESIDENT
200 TINTERN CT STE 111
CHESAPEAKE VA 23320

Organization’s website
Organization’s email ADMIN@MASFSUPPLEMENTS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/2020
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I60 - Law Enforcement Agencies (Police Departments)
Organization’s purpose Charitable: Yes
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 MITCHELL AGUIAR
Signature Title PRESIDENT
Signature Date 10/8/2020

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