FORM 1023-EZ for DISRUPTHR SIOUX FALLS

Field Data
EIN 81-4932122
Case Number EO-2017100-000207
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DISRUPTHR SIOUX FALLS
Organization’s Mailing Address 1001 W 12TH ST
City SIOUX FALLS
State SD
ZIP 57104-4203
Accounting period End 12
Primary contact name CHARLOTTE GAMBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLOTTE GAMBER
PRESIDENT
1001 W 12TH ST
SIOUX FALLS SD 57104-4203

Officer/Director/Trustee Two

KELSEY HILLBERG
VICE PRESIDENT
4300 S HOLBROOK
SIOUX FALLS SD 57106-1612

Officer/Director/Trustee Three

JAMIE BAKKER
TREASURER
8812 W WISEMAN CIR
SIOUX FALLS SD 57106-4882

Officer/Director/Trustee Four

CHRISTINA ENGEMAN
SECRETARY
4700 S BAHA AVE APT 26
SIOUX FALLS SD 57106-2293

Officer/Director/Trustee Five

CHRISTI PEASE
MARKETING/SOCIAL MEDIA DIRECTOR
3900 S OUTFIELD AVE
SIOUX FALLS SD 57110-4110

Organization’s website
Organization’s email DISRUPTHRSIOUXFALLS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/2016
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B02 - Management & Technical Assistance
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
One Third Support Gifts No
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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