FORM 1023-EZ for SACRED GROUNDS COFFEE HOUSE

Field Data
EIN 86-2395924
Case Number EO-2021120-000247
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SACRED GROUNDS COFFEE HOUSE
Organization’s Mailing Address 224 JANICE ST
City SHOREVIEW
State MN
ZIP 55126
Accounting period End 12
Primary contact name JENNIFER URBAN - CAF NO 0308-14263R
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARAH MCGUINESS
PRESIDENT AND TREASURER
224 JANICE ST
SHOREVIEW MN 55126

Officer/Director/Trustee Two

REBECCA KRASKA
SECRETARY
1255 11TH AVE SW APT 303
FOREST LAKE MN 55025

Officer/Director/Trustee Three

ROSIE BLANC
DIRECTOR
1015 29TH AVE SE
MINNEAPOLIS MN 55414

Officer/Director/Trustee Four

MARIA MYLENE BUAN-BERTUCCI
DIRECTOR
9301 CEDAR LAKE RD S
ST LOUIS PARK MN 55426

Officer/Director/Trustee Five

MARK MCGUINESS
DIRECTOR
1004 FRONT AVE
ST PAUL MN 55103

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P28 - Neighborhood Centers, Settlement Houses
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 SARAH MCGUINESS
Signature Title PRESIDENT AND TREASURER
Signature Date 4/28/2021

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