FORM 1023-EZ for BIG LAKE YOUTH LACROSSE ASSOCIATION

Field Data
EIN 47-1020238
Case Number EO-2020113-000007
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BIG LAKE YOUTH LACROSSE ASSOCIATION
Organization’s Mailing Address PO BOX 622
City BIG LAKE
State MN
ZIP 55309
Accounting period End 8
Primary contact name JODI KIPKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICK MERTEN
PRESIDENT
PO BOX 622
BIG LAKE MN 55309

Officer/Director/Trustee Two

BRAD BLEYMEYER
VICE PRESIDENT
PO BOX 622
BIG LAKE MN 55309

Officer/Director/Trustee Three

JODI KIPKA
TREASURER/SECRETARY
PO BOX 622
BIG LAKE MN 55309

Officer/Director/Trustee Four

BRIAN ERLANDSON
BOARD MEMBER
PO BOX 622
BIG LAKE MN 55309

Officer/Director/Trustee Five

LYNDSEY STEWART
BOARD MEMBER
PO BOX 622
BIG LAKE MN 55309

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/2020
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 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 RICK MERTEN
Signature Title PRESIDENT
Signature Date 4/17/2020

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