FORM 1023-EZ for SIOUX RAPIDS ALTA ASSOCIATION USBC

Field Data
EIN 84-1692619
Case Number EO-2016132-000082
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SIOUX RAPIDS ALTA ASSOCIATION USBC
Organization’s Mailing Address 1109 440TH ST
City SIOUX RAPIDS
State IA
ZIP 50585
Accounting period End 12
Primary contact name JILL HENNINGSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JILL HENNINGSEN
ASSOCIATION MANAGER
1109 440TH ST
SIOUX RAPIDS IA 50585

Officer/Director/Trustee Two

DAVE FREESE
PRESIDENT
410 MAIN STREET
ALTA IA 51002

Officer/Director/Trustee Three

STACY LONNING
VICE PRESIDENT
PO BOX 190
SIOUX RAPIDS IA 50585

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2006
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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