FORM 1023-EZ for EAST TWIN LAKE ASSOCIATION

Field Data
EIN 41-1787783
Case Number EO-2016266-000242
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EAST TWIN LAKE ASSOCIATION
Organization’s Mailing Address 4841 OLSON ROAD
City PEQUOT LAKES
State MN
ZIP 56472
Accounting period End 12
Primary contact name THOMAS ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS ADAMS
PRESIDENT
4841 OLSON ROAD
PEQUOT LAKES MN 56472

Officer/Director/Trustee Two

MARK WIEBOLT
TREASURER
27439 COUNTY ROAD 107
PEQUOT LAKES MN 56472

Officer/Director/Trustee Three

TIFFANY JACOBS
SECRETARY
2617 BROOKDALE LANE
BROOKLYN PARK MN 55444

Officer/Director/Trustee Four

KAREN BOLLER
BOARD MEMBER
27465 COUNTY ROAD 107
PEQUOT LAKES MN 56472

Officer/Director/Trustee Five

DAVID MORRIS
BOARD MEMBER
9029 NANTWICK RIDGE
BROOKLYN PARK MN 55443

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/13/1994
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C01 - Alliance/Advocacy Organizations
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 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
Signature Title
Signature Date

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