FORM 1023-EZ for TEAM DISCIPLINE TAEKWONDO BOOSTER CLUB

Field Data
EIN 82-1825991
Case Number EO-2017167-000257
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEAM DISCIPLINE TAEKWONDO BOOSTER CLUB
Organization’s Mailing Address 4699 358TH ST
City NORTH BRANCH
State MN
ZIP 55056
Accounting period End 12
Primary contact name SCOTT HANNAH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT HANNAH
PRESIDENT
5370 406TH ST
NORTH BRANCH MN 55056

Officer/Director/Trustee Two

JEREMY JOHNSON
VICE PRESIDENT
6589 378TH ST
NORTH BRANCH MN 55056

Officer/Director/Trustee Three

JACKIE BERLINGAME
SECRETARY
940 14TH LN SE
CAMBRIDGE MN 55008

Officer/Director/Trustee Four

DENNIS KENNY
TREASURER
6530 377TH ST
NORTH BRANCH MN 55056

Officer/Director/Trustee Five

SARAH ESGET
PUBLICITY DIRECTOR
9393 253RD AVE NE
STACY MN 55079

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2017
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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
Signature Title
Signature Date

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