FORM 1023-EZ for NORTH DAKOTA ACTIVE TRANSPORTATIONALLIANCE

Field	Data
EIN	35-2575215
Case Number	EO-2019052-000234
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	NORTH DAKOTA ACTIVE TRANSPORTATIONALLIANCE
Organization’s Mailing Address	508 19TH AVENUE WEST UNIT G
City	WEST FARGO
State	ND
ZIP	58078-4640
Accounting period End	12
Primary contact name	JUSTIN KRISTAN
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00

Officer/Director/Trustee One

MARK HAGEN
CHAIRMAN
839 264TH STREET SOUTH
HAWLEY MN 56549-9246

Officer/Director/Trustee Two

ALLEN THOMPSON
VICE CHAIRMAN
110 10TH AVENUE NORTHWEST APT 2
MANDAN ND 58554-3731

Officer/Director/Trustee Three

SARAH KIRKPATRICK
SECRETARY
152 32ND AVENUE NORTHEAST
FARGO ND 58102-1257

Officer/Director/Trustee Four

RANDEE REISER
TREASURER
421 LIBERTY LANE
HORACE ND 58047-4524

Officer/Director/Trustee Five

JUSTIN KRISTAN
EXECUTIVE DIRECTOR
508 19TH AVENUE WEST UNIT G
WEST FARGO ND 58078-4640

Organization’s website	HTTPS://NDACTIVETRANSPORTATIONALLIANCE.COM/
Organization’s email	ACTIVE_LIVING_32@LIVE.COM
Organization Incorporated	Yes
Organization trust	No
Necessary Organizing Documents	Yes
Organization Incorporation Date	10/11/16
Organization Incorporation State	ND
Contains Limitation	Yes
Does not expressly empower	Yes
Contains dissolution	Yes
National Taxonomy of Exempt Entities (NTEE) code	M40 - Safety Education
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	Yes
Compensation of Officer director trustee	Yes
Donation of funds	Yes
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	JUSTIN KRISTAN
Signature Title	EXECUTIVE DIRECTOR
Signature Date	2/19/19
EIN	35-2575215
Case Number	EO-2019052-000234
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	NORTH DAKOTA ACTIVE TRANSPORTATION ALLIANCE
Organization’s Mailing Address	508 19TH AVENUE WEST UNIT G
City	WEST FARGO
State	ND
ZIP	58078-4640
Accounting period End	12
Primary contact name	JUSTIN KRISTAN
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00