FORM 1023-EZ for QUAD COUNTY MAT CLUB

Field Data
EIN 46-1172164
Case Number EO-2015114-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QUAD COUNTY MAT CLUB
Organization’s Mailing Address 310 8TH AVE
City GRANITE FALLS
State MN
ZIP 56241
Accounting period End 12
Primary contact name ROBERT ATOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT ATOR
PRESIDENT
310 8TH AVE
GRANITE FALLS MN 56241

Officer/Director/Trustee Two

CARMEL THEIN
VICE PRESIDENT
732 NORTHWEST 5TH STREET
CLARA CITY MN 56222

Officer/Director/Trustee Three

JENNIFER KATTEVOLD
TRESURER
88244 STATE HWY 23
MAYNARD MN 56260

Officer/Director/Trustee Four

TERESA HILDAHL
SECRETARY
315 12TH AVE
GRANITE FALLS MN 56241

Officer/Director/Trustee Five

ANN JOHNSON
DIRECTOR
105 MAIN STREET NORTH
RENVILLE MN 56284

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/2013
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 Yes
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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