FORM 1023-EZ for ROGERS ROYALS LACROSSE BOOSTER CLUB

Field Data
EIN 81-1145845
Case Number EO-2016028-000140
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROGERS ROYALS LACROSSE BOOSTER CLUB
Organization’s Mailing Address 21000 141ST AVENUE
City ROGERS
State MN
ZIP 55374
Accounting period End 12
Primary contact name LOUIS MERTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LOUIS MERTZ
PRESIDENT
5887 QUALE AVENUE NE
SAINT MICHAEL MN 55376

Officer/Director/Trustee Two

LISA PRZYBILLA
TREASURER
12623 ELM PARKWAY
ROGERS MN 55374

Officer/Director/Trustee Three

CAROLINE CARROLL
SECRETARY
14379 95TH STREET NE
OTSEGO MN 55330

Officer/Director/Trustee Four

MELISSA BEAUDRY
EQUIPMENT MANAGER
22333 JED DRIVE
ROGERS MN 55374

Officer/Director/Trustee Five

BRETT CARLSON
VICE PRESIDENT
14405 DEHNSFIELD ROAD
ROGERS MN 55374

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/8/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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