FORM 1023-EZ for PEAK SPORTS CARE

Field Data
EIN 84-4078003
Case Number EO-2020002-000174
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PEAK SPORTS CARE
Organization’s Mailing Address 7300 GALLAGHER DRIVE APT 301
City EDINA
State MN
ZIP 55435
Accounting period End 12
Primary contact name JORDAN KNOWLTON-KEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JORDAN KNOWLTON-KEY
CHAIR
7300 GALLAGHER DRIVE APT 301
EDINA MN 55435

Officer/Director/Trustee Two

SRIPATHY UMAPATHI
SECRETARY
3413 E 40TH ST
MINNEAPOLIS MN 55406

Officer/Director/Trustee Three

BETH ANTOINE
TREASURER
376 W JOHNSON ST UNIT 4
RIVER FALLS WI 54022

Officer/Director/Trustee Four

RYAN OSTER
VICE-CHAIR
2138 CLEVELAND WAY S
CAMBRIDGE MN 55008

Organization’s website
Organization’s email PEAKSPORTSCARE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2019
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JORDAN KNOWLTON-KEY
Signature Title CHAIR
Signature Date 12/30/2019

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