FORM 1023-EZ for CENTRAL MINNESOTA CIRCLE OF HEALTH

Field Data
EIN 46-4923252
Case Number EO-2016344-000242
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CENTRAL MINNESOTA CIRCLE OF HEALTH
Organization’s Mailing Address 1300 GODWARD STREET NE SUITE 2500
City MINNEAPOLIS
State MN
ZIP 55413-1878
Accounting period End 12
Primary contact name MANDY RUBENSTEIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK ZOOK
PRESIDENT
1301 33RD ST S
ST. CLOUD MN 56301-9668

Officer/Director/Trustee Two

CHRISTOPHER WENNER
PAST PRESIDENT
218 MAIN ST
COLD SPRING MN 56320-2533

Officer/Director/Trustee Three

ANN LEE
TREASURER
1301 33RD ST S
ST. CLOUD MN 56301-9668

Officer/Director/Trustee Four

MOHAMED YASSIN
BOARD MEMBER
1511 NORTHWAY DR STE 101
ST. CLOUD MN 56303-1262

Officer/Director/Trustee Five

GEORGE SCHOEPHOERSTER
BOARD MEMBER
3702 STERLING DR
ST. CLOUD MN 56301-9551

Organization’s website
Organization’s email MRUBENSTEIN@MNMED.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G83 - Alzheimer's Disease
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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