FORM 1023-EZ for OPERATION RESTORE ORAL HEALTH

Field Data
EIN 82-2679502
Case Number EO-2017251-000520
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OPERATION RESTORE ORAL HEALTH
Organization’s Mailing Address 1745 NORTHWESTERN AVE S
City STILLWATER
State MN
ZIP 55082
Accounting period End 12
Primary contact name RANDY KOPESKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDY KOPESKY
EXECUTIVE DIRECTOR
1745 NORTHWESTERN AVE S
STILLWATER MN 55082

Officer/Director/Trustee Two

CHARLES MARAGOS
BOARD MEMBER
1745 NORTHWESTERN AVE S
STILLWATER MN 55082

Officer/Director/Trustee Three

N RAY LEE
BOARD MEMBER
1745 NORTHWESTERN AVE S
STILLWATER MN 55082

Officer/Director/Trustee Four

LYMAN STEIL
BOARD MEMBER
1745 NORTHWESTERN AVE S
STILLWATER MN 55082

Officer/Director/Trustee Five

DEAN MARAGOS
BOARD MEMBER
1745 NORTHWESTERN AVE S
STILLWATER MN 55082

Organization’s website N/A
Organization’s email RKOPESKY@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/2017
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical Services
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 Yes
Donation of funds Yes
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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