FORM 1023-EZ for MONDOVI FOOTBALL BOOSTER CLUB

Field Data
EIN 83-0639961
Case Number EO-2018197-000288
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MONDOVI FOOTBALL BOOSTER CLUB
Organization’s Mailing Address PO BOX 1
City MONDOVI
State WI
ZIP 54755
Accounting period End 12
Primary contact name BARRETT BRENNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BARRETT BRENNER
TREASURER
348 MIRROR LAKE DRIVE
MONDOVI WI 54755

Officer/Director/Trustee Two

ANDREW VAN ROO
CLERK
W124 US HIGHWAY 10
MONDOVI WI 54755

Officer/Director/Trustee Three

CRAIG LOSCHEIDER
PRESIDENT
S405 STATE ROAD 37
MONDOVI WI 54755

Officer/Director/Trustee Four

CHRIS RUD
VICE PRESIDENT
W682 COUNTY RD H
MONDOVI WI 54755

Organization’s website N/A
Organization’s email BBRENNER@CHIMNEYROCKAPPRAISAL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
Organization’s purpose Charitable: Yes
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 BARRETT BRENNER
Signature Title TREASURER
Signature Date 7/12/18

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