FORM 1023-EZ for INDIAN NATIONS BLUES ASSOCIATION

Field Data
EIN 82-4579091
Case Number EO-2018067-000184
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INDIAN NATIONS BLUES ASSOCIATION
Organization’s Mailing Address PO BOX 397
City PAWHUSKA
State OK
ZIP 74056
Accounting period End 12
Primary contact name STEVE ANTRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE ANTRY
CHAIRMAN OF THE BOARD
6100 S YALE AVE / SUITE 700
TULSA OK 74136

Officer/Director/Trustee Two

NATHAN ALESSI
PRESIDENT AND BOARD MEMBER
6100 S YALE AVE / SUITE 700
TULSA OK 74136

Officer/Director/Trustee Three

PETER CARSON
BAORD MEMBER
424 WESLEY AVE
ST LOUIS MO 63135

Officer/Director/Trustee Four

LAUREN CARSON
VP AND BOARD MEMBER
71-15 DITMARS BLVE / UNIT 1
EAST ELMHURST NY 11370

Officer/Director/Trustee Five

STEPHANIE LOFTUS
VICE PRESIDENT
923 WEST C STREET
JENKS OK 74037

Organization’s website WWW.INDBA.COM
Organization’s email ANTRYMUSIC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/18
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STEVE ANTRY
Signature Title CHAIRMAN OF THE BOARD
Signature Date 3/6/18

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