FORM 1023-EZ for HENRY SIBLEY ROBOTICS

Field Data
EIN 83-0904663
Case Number EO-2018172-000196
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HENRY SIBLEY ROBOTICS
Organization’s Mailing Address 959 DELAWARE AVENUE
City MENDOTA HEIGHTS
State MN
ZIP 55118
Accounting period End 12
Primary contact name DANIEL HALSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL HALSEY
PRESIDENT
959 DELAWARE AVENUE
MENDOTA HEIGHTS MN 55118

Officer/Director/Trustee Two

NOEL MOLINA
DIRECTOR
1185 MACARTHUR AVE
WEST ST PAUL MN 55118

Officer/Director/Trustee Three

CARLE CHEESEBROUGH
DIRECTOR
887 CHERI LANE
MENDOTA HEIGHTS MN 55118

Organization’s website WWW.TEAM3100.COM
Organization’s email 3100LIGHTNINGTURTLES@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 DANIEL HALSEY
Signature Title PRESIDENT
Signature Date 6/19/18

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