FORM 1023-EZ for STATESMEN

Field Data
EIN 84-3245138
Case Number EO-2019305-000202
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STATESMEN
Organization’s Mailing Address PO BOX 321
City MEADE
State KS
ZIP 67864
Accounting period End 12
Primary contact name CHAD ZIEBART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD ZIEBART
PRESIDENT
607 N SPRINGLAKE
MEADE KS 67864

Officer/Director/Trustee Two

ANDREW GLENN
VICE-PRESIDENT
310 W LEA
FOWLER KS 67844

Officer/Director/Trustee Three

JAKE SHREWSBURY
SECRETARY
611 S BRIAN
MEADE KS 67864

Officer/Director/Trustee Four

RICHARD ROBERTS
TREASURER
20138 9 RD
PLAINS KS 67869

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/19
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 Yes
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 CHAD ZIEBART
Signature Title PRESIDENT
Signature Date 10/30/19

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