FORM 1023-EZ for POUND THE ROCK MEMORIAL SCHOLARSHIP

Field Data
EIN 84-2887941
Case Number EO-2019246-000280
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POUND THE ROCK MEMORIAL SCHOLARSHIP
Organization’s Mailing Address 8326 WYOMING TRAIL
City CHISAGO CITY
State MN
ZIP 55013
Accounting period End 12
Primary contact name BENJAMIN J KLASSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRISTIN PITLIK
PRESIDENT/CEO
5010 SAND LAKE ROAD
EAGLE RIVER WI 54521

Officer/Director/Trustee Two

KAREN PETERSON
DIRECTOR
8326 WYOMING TRAIL
CHISAGO CITY MN 55013

Officer/Director/Trustee Three

MICHAEL PETERSON
DIRECTOR
8326 WYOMING TRAIL
CHISAGO CITY MN 55013

Officer/Director/Trustee Four

MARIAH STOECKMAN
DIRECTOR
29119 SCENIC DRIVE
CHISAGO CITY MN 55013

Officer/Director/Trustee Five

JONATHON PETERSON
DIRECTOR
8326 WYOMING TRAIL
CHISAGO CITY MN 55013

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/29/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KRISTIN PITLIK
Signature Title PRESIDENT/CEO
Signature Date 8/30/19

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