FORM 1023-EZ for AMTGARD POLARIS

Field Data
EIN 47-4826529
Case Number EO-2017111-000238
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMTGARD POLARIS
Organization’s Mailing Address 513 6TH STREET
City WAUNAKEE
State WI
ZIP 53597
Accounting period End 12
Primary contact name JON SHENKIR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD STROHMEYER
PRESIDENT
1001 SHERBURNE AVE
SAINT PAUL MN 55104

Officer/Director/Trustee Two

BETH SCARAMUZZA
TREASURER
9040 CHEROKEE DRIVE N
BROOKLYN PARK MN 55428

Officer/Director/Trustee Three

JOCELYN ZASTROQ
SECRETARY
2384 CANTER IN UNIT A
GREEN BAY WI 54304

Officer/Director/Trustee Four

ANDREW CARLETON
MEMBER
310 N 6TH STREET
LAKE CITY MN 55041

Officer/Director/Trustee Five

GARY SOBIESKI
MEMBER
1332 E MASON ST APT 1
GREEN BAY WI 54301

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/17/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A99 - Arts, Culture, and Humanities N.E.C.
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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