FORM 1023-EZ for PETERSBURG ROK N BLOCKERS

Field Data
EIN 46-5195767
Case Number EO-2015119-000423
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PETERSBURG ROK N BLOCKERS
Organization’s Mailing Address PO BOX 1354
City PETERSBURG
State AK
ZIP 99833-1354
Accounting period End 12
Primary contact name KATHLEEN GILPIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATTI STEELE
PRESIDENT, DIRECTOR
PO BOX 2004
PETERSBURG AK 99833-2004

Officer/Director/Trustee Two

KATHLEEN GILPIN
SECRETARY/TREASURER, DIRECTOR
PO BOX 1511
PETERSBURG AK 99833-1511

Officer/Director/Trustee Three

LISA NILSEN
DIRECTOR
PO BOX 1822
PETERSBURG AK 99833-1822

Officer/Director/Trustee Four

MERRICK NILSEN
VICE PRESIDENT, DIRECTOR
PO BOX 1822
PETERSBURG AK 99833-1822

Officer/Director/Trustee Five

MIRANDA NILSEN
SGT.AT ARMS, DIRECTOR
PO BOX 1822
PETERSBURG AK 99833-1822

Organization’s website
Organization’s email ROKNBLOCKERS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/2014
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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