FORM 1023-EZ for BRETT SMITH MEMORIAL

Field Data
EIN 46-5529312
Case Number EO-2015127-000346
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BRETT SMITH MEMORIAL
Organization’s Mailing Address 1924 HIGHWAY 1 NE
City SOLON
State IA
ZIP 52333
Accounting period End 12
Primary contact name MICHAEL R MAYHEW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEFF SMITH
DIRECTOR
WEST SOVERS STREET
SOLON IA 52333

Officer/Director/Trustee Two

THERESA MAYHEW
DIRECTOR
2074 ST BRIDGETS ROAD NE
SOLON IA 52333

Officer/Director/Trustee Three

SARAH DREA
DIRECTOR
1924 HIGHWAY 1 NE
SOLON IA 52333

Officer/Director/Trustee Four

SANDY WILLEY
DIRECTOR
4006 CRESTVIEW ROAD NE
SOLON IA 52333

Officer/Director/Trustee Five

MIKE MAYHEW
DIRECTOR
2205 MAREN COURT
EAU CLAIRE WI 54703

Organization’s website N/A
Organization’s email MIKE.MAYHEW@CLACONNECT.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U20 - Science, General
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 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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