FORM 1023-EZ for WAVERLY-SHELL ROCK TRAPSHOOTING CLUB LLC

Field Data
EIN 83-0876507
Case Number EO-2018270-000407
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WAVERLY-SHELL ROCK TRAPSHOOTING CLUB LLC
Organization’s Mailing Address 1213 SHEPHERD AVE
City WAVERLY
State IA
ZIP 50677
Accounting period End 12
Primary contact name SCOTT KAISAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT KAISAND
PRESIDENT
1213 SHEPHERD
WAVERLY IA 50677

Officer/Director/Trustee Two

DARIN FROELICH
VICE PRESIDENT
2078 IVY AVENUE
WAVERLY IA 50677

Officer/Director/Trustee Three

JENNIFER STEINBRONN
SECRETARY
1402 LEITHA TERRACE
WAVERLY IA 50677

Officer/Director/Trustee Four

JOHN DUNAKEY
DIRECTOR
22896 LAKE RD
SHELL ROCK IA 50670

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/18
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
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 SCOTT KAISAND
Signature Title PRESIDENT
Signature Date 9/25/18

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