FORM 1023-EZ for BLAINE NORDIC BOOSTER CLUB

Field Data
EIN 83-1848780
Case Number EO-2018261-000187
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLAINE NORDIC BOOSTER CLUB
Organization’s Mailing Address 2329 130TH CT NE
City BLAINE
State MN
ZIP 55449-3903
Accounting period End 3
Primary contact name BOB BENNETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT BENNETT
PRESIDENT
2329 130TH CT NE
BLAINE MN 55449-3903

Officer/Director/Trustee Two

SARAH BARNETT
SECRETARY
12364 RENDOVA ST NE
BLAINE MN 55449

Officer/Director/Trustee Three

JANET LEWIS
TREASURER
1810 140TH LANE NE
HAM LAKE MN 55304

Officer/Director/Trustee Four

DARCI OLSON
VICE PRESIDENT
12410 GOLDENROD ST NW
COON RAPIDS MN 55448

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 Yes
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 ROBERT BENNETT
Signature Title PRESIDENT
Signature Date 9/16/18

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