FORM 1023-EZ for QUAD CITY ROCKET CLUB

Field Data
EIN 84-3353477
Case Number EO-2020302-000381
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name QUAD CITY ROCKET CLUB
Organization’s Mailing Address 25996 N 2750 ROAD
City VAN ORIN
State IL
ZIP 61374
Accounting period End 12
Primary contact name SUSAN LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIMOTHY LEHR
PRESIDENT
25996 2750 N STREET
VAN ORIN IL 61374

Officer/Director/Trustee Two

BRADFORD WILSON
VICE PRESIDENT
903 E 6TH STREET
STERLING IL 61081

Officer/Director/Trustee Three

ADRIAN BUTLER
PREFECT
5430 S MALTA ROAD
MALTA IL 60150

Officer/Director/Trustee Four

GARY KAWABATA
TREASURER
4240 SHADY TRAIL COURT UNIT 206
NAPERVILLE IL 60564

Officer/Director/Trustee Five

JANE DENALI
SECRETARY
1211 E BLUFF ROAD APT 206
WHITEWATER WI 53190

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/2019
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 GARY KAWABATA
Signature Title TREASURER
Signature Date 10/26/2020

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