FORM 1023-EZ for WESTBROOK AREA SERVICE CLUB

Field Data
EIN 85-3579498
Case Number EO-2021270-000385
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WESTBROOK AREA SERVICE CLUB
Organization’s Mailing Address 524 CEDAR AVENUE
City WESTBROOK
State MN
ZIP 56183
Accounting period End 12
Primary contact name MELISSA L GRAMS CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LOY WOELBER
CHAIR
2590 121ST STREET
AVOCA MN 56114

Officer/Director/Trustee Two

STEVEN KJORNESS
VICE CHAIR
508 EDISON AVENUE
WESTBROOK MN 56183

Officer/Director/Trustee Three

JANET JOHNSON
TREASURER
524 CEDAR AVENUE
WESTBROOK MN 56183

Officer/Director/Trustee Four

ANITA PHELPS
SECRETARY
824 ADAMS AVENUE
WESTBROOK MN 56183

Organization’s website NONE
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2020
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 JANET JOHNSON
Signature Title TREASURER
Signature Date 9/23/2021

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