FORM 1023-EZ for GRAND CONNECT FM

Field Data
EIN 86-2337708
Case Number EO-2021093-000511
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRAND CONNECT FM
Organization’s Mailing Address 2855 LONGFELLOW RD N
City FARGO
State ND
ZIP 58102
Accounting period End 12
Primary contact name ANDREW SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW SMITH
DIRECTOR
6733 60TH AVE S
FARGO ND 58104

Officer/Director/Trustee Two

BRADY BLOMBERG
DIRECTOR
2855 LONGFELLOW ROAD N
FARGO ND 58102

Officer/Director/Trustee Three

DARIN UNDERHILL
DIRECTOR
2614 6TH ST W
WEST FARGO ND 58078

Officer/Director/Trustee Four

KATIE LARSON
DIRECTOR
3054 32ND ST S
FARGO ND 58103

Officer/Director/Trustee Five

KELLY COLLINS
DIRECTOR
441 CLEARVIEW COURT
MOORHEAD MN 56560

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2021
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 ANDREW SMITH
Signature Title DIRECTOR
Signature Date 3/1/2021

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