FORM 1023-EZ for NORTHERN LAKES AQUATIC CLUB INC

Field Data
EIN 85-3167266
Case Number EO-2020279-000338
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTHERN LAKES AQUATIC CLUB INC
Organization’s Mailing Address 1961 LAKE ROAD
City MONICO
State WI
ZIP 54501
Accounting period End 8
Primary contact name ROB MEYER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROB MEYER
PRESIDENT
1961 LAKE ROAD
MONICO WI 54501

Officer/Director/Trustee Two

KRISTIE WINTER
BOARD MEMBER
1203 HARRISON STREET
MERRILL WI 54452

Officer/Director/Trustee Three

CHRIS GARCIA
BOARD MEMBER
10641 LOWER KAUBASHINE
HAZELHURST WI 54531

Officer/Director/Trustee Four

SHARI BERGMAN
BOARD MEMBER
907 SHATTUCK STREET
MEDFORD WI 54451

Officer/Director/Trustee Five

BOB BURDORF
BOARD MEMBER
PO BOX 67
WEYERHAUSER WI 54895

Organization’s website NLACSWIMMING.TEAMPAGES.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 ROB MEYER
Signature Title PRESIDENT
Signature Date 10/1/2020

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