FORM 1023-EZ for NEBRASKA MIDDLE LEVEL ACADEMY

Field Data
EIN 47-0775913
Case Number EO-2017321-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NEBRASKA MIDDLE LEVEL ACADEMY
Organization’s Mailing Address 3830 V ROAD
City BRUNO
State NE
ZIP 68014
Accounting period End 12
Primary contact name LORI FOCHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID ESSINK
PRESIDENT
201 N MARIAN ROAD
HASTINGS NE 68901

Officer/Director/Trustee Two

AUDREY MILLER
SECRETARY
622 E HILLCREST DR
SEWARD NE 68434

Officer/Director/Trustee Three

LORI FOCHER
TREASURER
3830 V ROAD
BRUNO NE 68014

Officer/Director/Trustee Four

PATRICIA BRUNER
TRUSTEE
2504 9TH AVENUE
KEARNEY NE 68849

Officer/Director/Trustee Five

NICHOLE KRAUS
TRUSTEE
1600 N CUSTER AVE
GRAND ISLAND NE 68803

Organization’s website
Organization’s email LFOCHER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/4/1994
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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