FORM 1023-EZ for BIKE CHIPPEWA VALLEY

Field Data
EIN 84-2052026
Case Number EO-2019176-000111
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BIKE CHIPPEWA VALLEY
Organization’s Mailing Address 435 SO WILLSON DR
City ALTOONA
State WI
ZIP 54720
Accounting period End 6
Primary contact name DEAN ROTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEREMY GRAGERT
PRESIDENT
451 LINCOLN AVE
EAU CLAIRE WI 54701-4094

Officer/Director/Trustee Two

ROY ATKINSON
VICE PRESIDENT
610 GREY ST
EAU CLAIRE WI 54701-3787

Officer/Director/Trustee Three

DEAN ROTH
SECRETARY
435 S WILLSON DR
ALTOONA WI 54720-1344

Officer/Director/Trustee Four

RICHARD JOHNSON
TREASURER
1709 TAFT AVE
EAU CLAIRE WI 54701-6693

Officer/Director/Trustee Five

AARON SALMON
MEMBER AT LARGE
615 GRAHAM AV
EAU CLAIRE WI 54701-3839

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/19
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
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 DEAN ROTH
Signature Title SECRETARY
Signature Date 6/20/19

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