FORM 1023-EZ for BUCKLEUPBLUE4LAURYN INC

Field Data
EIN 84-4135885
Case Number EO-2020041-000494
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BUCKLEUPBLUE4LAURYN INC
Organization’s Mailing Address 15 SOUTH DIVISION
City FAIRFIELD
State MT
ZIP 59436
Accounting period End 12
Primary contact name KADEN KETO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK GOLDHAHN
DIRECTOR
15 SOUTH DIVISION
FAIRFIELD MT 59436

Officer/Director/Trustee Two

WINDIE GOLDHAHN
DIRECTOR
15 SOUTH DIVISION
FAIRFIELD MT 59436

Officer/Director/Trustee Three

ALLIX GOLDHAHN
DIRECTOR
15 SOUTH DIVISION
FAIRFIELD MT 59436

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2020
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W01 - Alliance/Advocacy Organizations
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PATRICK GOLDHAHN
Signature Title DIRECTOR
Signature Date 2/7/2020

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