FORM 1023-EZ for COMMUNITY CAFE

Field Data
EIN 47-3126647
Case Number EO-2015146-000311
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY CAFE
Organization’s Mailing Address 515 2ND AVENUE NW
City FARIBAULT
State MN
ZIP 55021-4203
Accounting period End 12
Primary contact name CAROLYN TREADWAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROLYN TREADWAY
PRESIDENT
631 4TH AVENUE SW
FARIBAULT MN 55021-6119

Officer/Director/Trustee Two

JAN BATCHELDER
TREASURER
502 5TH STREET NW
FARIBAULT MN 55021-4105

Officer/Director/Trustee Three

JUSTIN CHAPMAN
BOARD MEMBER
1430 15TH AVE NW
ROCHESTER MN 55901-1651

Officer/Director/Trustee Four

KATHERINE KATHARINE
SECRETARY
19937 IVANHOE CT
FARIBAULT MN 55021-7593

Officer/Director/Trustee Five

RENEE MORRIS
BOARD MEMBER
21731 LAKE AVE
WATERVILLE MN 56096-9321

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K34 - Congregate Meals
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
Signature Title
Signature Date

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