FORM 1023-EZ for ELKHORN KWIK STX INC

Field Data
EIN 47-5226176
Case Number EO-2015350-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ELKHORN KWIK STX INC
Organization’s Mailing Address P O BOX 152
City ELKHORN
State WI
ZIP 53121
Accounting period End 12
Primary contact name MICHAEL SHOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL SHOR
PRESIDENT
P O BOX 152
ELKHORN WI 53121

Officer/Director/Trustee Two

KEVIN GAHART
VICE PRESIDENT
239 WINSOR ST
ELKHORN WI 53121

Officer/Director/Trustee Three

LANA PLANT
SECRETARY
N6076 BALSAM
ELKHORN WI 53121

Officer/Director/Trustee Four

JEFF KIESPERT
TREASURER
W4641 RIDGEVIEW RD
ELKHORN WI 53121

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/22/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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
Signature Title
Signature Date

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