FORM 1023-EZ for FOC COMMUNITY CLUB

Field Data
EIN 81-2352659
Case Number EO-2019262-000149
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOC COMMUNITY CLUB
Organization’s Mailing Address PO BOX 142
City CHASEBURG
State WI
ZIP 54621
Accounting period End 12
Primary contact name RANDY HUMFELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MITCH WILSON
PRESIDENT
E5898 COUNTY RD GG
WESTBY WI 54667

Officer/Director/Trustee Two

RANDY HUMFELD
TREASURER
E3498 HUMFELD LANE
CHASEBURG WI 54621

Officer/Director/Trustee Three

ERIC OSTREM
SECRETARY
W3195 COUNTY RD N
COON VALLEY WI 54623

Officer/Director/Trustee Four

JOSEPH BERRA
VICE PRESIDENT
S1582 COUNTY RD K
CHASEBURG WI 54621

Officer/Director/Trustee Five

MASON OSTREM
DIRECTOR
200 ROCK ST
CHASEBURG WI 54621

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/16
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RANDY HUMFELD
Signature Title TREASURER
Signature Date 9/17/19
EIN 81-2352659
Case Number EO-2018136-000487
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOC COMMUNITY CLUB
Organization’s Mailing Address PO BOX 142
City CHASEBURG
State WI
ZIP 54621
Accounting period End 12
Primary contact name RANDY HUMFELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL SCHROEDER
PRESIDENT
S1282 LANGAARD LN
CHASEBURG WI 54621

Officer/Director/Trustee Two

RANDY HUMFELD
TREASURER
E3498 HUMFELD LN
CHASEBURG WI 54621

Officer/Director/Trustee Three

ERIC OSTREM
SECRETARY
W3195 COUNTY RD N
COON VALLEY WI 54623

Officer/Director/Trustee Four

BRUCE VON RUDEN
VICE PRESIDENT
S1815A STATE HIGHWAY 162
CHASEBURG WI 54621

Officer/Director/Trustee Five

RICHARD SCHULTZ
DIRECTOR
S1474 HAGEN LN
CHASEBURG WI 54621

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/16
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 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 RANDY HUMFELD
Signature Title TREASURER
Signature Date 5/14/18

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