FORM 1023-EZ for RENVILLE COUNTY AQUATIC CLUB

Field Data
EIN 46-4048231
Case Number EO-2014254-000648
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RENVILLE COUNTY AQUATIC CLUB
Organization’s Mailing Address 801 EAST LINCOLN AVENUE - PO BOX 87
City OLIVIA
State MN
ZIP 56277
Accounting period End 12
Primary contact name NANETTE SERBUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HEATHER THOMPSON
PRESIDENT
613 EAST WALNUT AVENUE
OLIVIA MN 56277

Officer/Director/Trustee Two

TRACEY JOHNSON-PROKOSCH
HEAD COACH
81985 380TH STREET
BIRD ISLAND MN 55310

Officer/Director/Trustee Three

LYNN HILLEMEIER
SECRETARY
1110 WEST OAK AVENUE
OLIVIA MN 56277

Officer/Director/Trustee Four

NANETTE SERBUS
TREASURER
75420 225TH STREET
RENVILLE MN 56284

Officer/Director/Trustee Five

VONNIE HAMMERSCHMIDT
VICE PRESIDENT
341 SOUTH 9TH STREET
BIRD ISLAND MN 55310

Organization’s website WWW.RCACORCAS.COM
Organization’s email RENVILLECOAQUATICCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/2013
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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