FORM 1023-EZ for SOUTHEAST IOWA DREAM CENTER

Field Data
EIN 84-2847038
Case Number EO-2019242-000172
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHEAST IOWA DREAM CENTER
Organization’s Mailing Address 133 W 2ND ST
City OTTUMWA
State IA
ZIP 52501
Accounting period End 12
Primary contact name RACHEL KOOISTRA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARTIN SCHMIDT
DIRECTOR
1556 N ELM ST
OTTUMWA IA 52501

Officer/Director/Trustee Two

RACHEL KOOISTRA
DIRECTOR
262 S WARD ST
OTTUMWA IA 52501

Officer/Director/Trustee Three

JOSEPH GEVOCK
DIRECTOR
20 GREENBRIAR LN
OTTUMWA IA 52501

Officer/Director/Trustee Four

DAVID HOPKINS
DIRECTOR
700 COUNTRYSIDE LN
PELLA IA 50219

Officer/Director/Trustee Five

TIFFANY REBER
DIRECTOR
9710 100TH AVE LOT 9
OTTUMWA IA 52501

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/19
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RACHEL KOOISTRA
Signature Title DIRECTOR
Signature Date 8/28/19

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