FORM 1023-EZ for BLUE AND WHITE SHIRTS

Field Data
EIN 46-1118348
Case Number EO-2016252-000120
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE AND WHITE SHIRTS
Organization’s Mailing Address P O BOX 321
City WAYMART
State PA
ZIP 18472
Accounting period End 12
Primary contact name CHARLES NORELLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES NORELLA
PRESIDENT
157 CARBONDALE ROAD
WAYMART PA 18472

Officer/Director/Trustee Two

HARRY SHAFFER
VICE PRESIDENT
113 SHAFFER ROAD
LAKE ARIEL PA 18435

Officer/Director/Trustee Three

FREDERICK GLAVICH
SECRETARY
199 MARION STREET
BROWNDALE PA 18421

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2012
Organization Incorporation State PA
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: No
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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