FORM 1023-EZ for ONE SHAKE IS ALL IT TAKES

Field Data
EIN 47-1329766
Case Number EO-2015091-000259
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ONE SHAKE IS ALL IT TAKES
Organization’s Mailing Address 621 JEFFERSON STREET
City RED WING
State MN
ZIP 55066
Accounting period End 12
Primary contact name CHRIS HEATH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KELSIE KUYATH
CHAIRPERSON/PRESIDENT
621 JEFFERSON STREET
RED WING MN 55066

Officer/Director/Trustee Two

CHRIS HEATH
CO-CHAIRPERSON
621 JEFFERSON STREET
RED WING MN 55066

Officer/Director/Trustee Three

BRITTANY KUYATH
SECRETARY/TREASURER
621 JEFFERSON STREET
RED WING MN 55066

Organization’s website HTTP://WWW.ONESHAKEISALLITTAKES.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/2014
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I72 - Child Abuse, Prevention of
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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