FORM 1023-EZ for THE CAR CLINIC

Field Data
EIN 47-2517134
Case Number EO-2015054-000159
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE CAR CLINIC
Organization’s Mailing Address 10728 TWIN LAKES PARKWAY NW
City ELK RIVER
State MN
ZIP 55330
Accounting period End 12
Primary contact name JOHN NELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TIM HILLER
DIRECTOR
10728 TWIN LAKES PARKWAY NW
ELK RIVER MN 55330

Officer/Director/Trustee Two

MICHELLE HILLER
DIRECTOR
10728 TWIN LAKES PARKWAY NW
ELK RIVER MN 55330

Officer/Director/Trustee Three

LYNETTE ROHDE
DIRECTOR
10728 TWIN LAKES PARKWAY NW
ELK RIVER MN 55330

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/10/2014
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T19 - Nonmonetary Support N.E.C.
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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