FORM 1023-EZ for ELLSWORTH COUNTY FAIR ASSOCIATION

Field Data
EIN 47-3917113
Case Number EO-2016035-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ELLSWORTH COUNTY FAIR ASSOCIATION
Organization’s Mailing Address 210 N KANSAS AVE STE 1
City ELLSWORTH
State KS
ZIP 67439
Accounting period End 9
Primary contact name SARAH DLABAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHELLE BROKES
PRESIDENT
715 2ND RD
WILSON KS 67490

Officer/Director/Trustee Two

TRAVIS JANSSEN
VICE PRESIDENT
1836 AVE Y
GENESEO KS 67444

Officer/Director/Trustee Three

LINDSEY HUSEMAN
SECRETARY
313 21ST RD
ELLSWORTH KS 67439

Officer/Director/Trustee Four

SARAH DLABAL
TREASURER
916 2ND RD
WILSON KS 67490

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/18/2015
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N52 - Fairs, County and Other
Organization’s purpose Charitable: No
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 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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