FORM 1023-EZ for ORTH MEMORIAL

Field Data
EIN 84-2518550
Case Number EO-2020055-000424
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ORTH MEMORIAL
Organization’s Mailing Address 7853 131ST ST W
City APPLE VALLEY
State MN
ZIP 55124
Accounting period End 12
Primary contact name ROBERT BRAUN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RACHEL LUCAS
DIRECTOR
2944 N 85TH STREET
MILWAUKEE WI 53222

Officer/Director/Trustee Two

SCOTT ORTH
DIRECTOR
614 19TH SE ST
ST CLOUD MN 56304

Officer/Director/Trustee Three

JOE LENTNER
DIRECTOR
1508 COBALT DR NW
RAMSEY MN 55303

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2019
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 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 RACHEL LUCAS
Signature Title DIRECTOR
Signature Date 2/20/2020

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