FORM 1023-EZ for SOUTHERN MINNESOTA SELECT SOCCER

Field Data
EIN 83-3765260
Case Number EO-2019193-000248
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHERN MINNESOTA SELECT SOCCER
Organization’s Mailing Address 1010 N DALE ST
City SAINT PAUL
State MN
ZIP 55117
Accounting period End 12
Primary contact name NATE BIRKHOLZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATE BIRKHOLZ
CHAIRMAN
4400 WEST 59TH ST UNIT 3
SIOUX FALLS SD 57108

Officer/Director/Trustee Two

RICK RHONE
BOARD MEMBER
1010 BUSH CT SW
EYOTA MI 55934

Officer/Director/Trustee Three

JAMES HARDEN
BOARD MEMBER
4048 SE MAIN AVE NO 139
ROCHESTER MI 55904

Officer/Director/Trustee Four

SCOT FIELD
BOARD MEMBER
1015 BUSH CT SW
EYOTA MI 55904

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 NATE BIRKHOLZ
Signature Title CHAIRMAN
Signature Date 7/10/19

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