FORM 1023-EZ for ACGC ATHLETICS BOOSTER CLUB

Field Data
EIN 30-0512579
Case Number EO-2018036-000034
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACGC ATHLETICS BOOSTER CLUB
Organization’s Mailing Address 27250 MN HWY 4
City GROVE CITY
State MN
ZIP 56243
Accounting period End 12
Primary contact name CHAD BUSSKOHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELLI ERICKSON
PRESIDENT
3490 COUNTY RD 4 NE
ATWATER MN 56209

Officer/Director/Trustee Two

CHAD BUSSKOHL
TREASURER
17720 30TH AVE NE
ATWATER MN 56209

Officer/Director/Trustee Three

MICHELE BUSSKOHL
SECRETARY
17720 30TH AVE NE
ATWATER MN 56209

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 CHAD BUSSKOHL
Signature Title TREASURER
Signature Date 2/1/18

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