FORM 1023-EZ for THE BAR GYM AND FITNESS STUDIO

Field Data
EIN 86-3023340
Case Number EO-2021260-000238
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BAR GYM AND FITNESS STUDIO
Organization’s Mailing Address 16 3RD AVE E PO BOX 43
City NEW LEIPZIG
State ND
ZIP 58562
Accounting period End 12
Primary contact name MISTY HAASE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MISTY HAASE
PRESIDENT & DIRECTOR
16 3RD AVE E PO BOX 43
NEW LEIPZIG ND 58562

Officer/Director/Trustee Two

MARY PIERSON
TREASURER & DIRECTOR
6735 54TH AVE SW
CARSON ND 58529

Officer/Director/Trustee Three

BECCA ZETOCHA
SECRETARY & DIRECTOR
409 E ST N
ELGIN ND 58533

Organization’s website
Organization’s email MISTYHAASE1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2021
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 MISTY HAASE
Signature Title PRESIDENT & DIRECTOR
Signature Date 9/15/2021

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