FORM 1023-EZ for MABEL-CANTON BOOSTER CLUB

Field Data
EIN 81-4529660
Case Number EO-2016336-000349
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MABEL-CANTON BOOSTER CLUB
Organization’s Mailing Address 45001 160TH STREET PO BOX 233
City MABEL
State MN
ZIP 55954-0233
Accounting period End 12
Primary contact name KAREN LARSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOBBIE VICKERMAN
DIRECTOR
311 EAST FILLMORE
MABEL MN 55954

Officer/Director/Trustee Two

MELISSA MILLER
DIRECTOR
10029 381ST AVENUE
MABEL MN 55954

Officer/Director/Trustee Three

HEATHER KLEIBOER
DIRECTOR
2387 COUNTY ROAD A14
DECORAH IA 52101

Officer/Director/Trustee Four

TINA MICHELS
DIRECTOR
3793 188TH AVENUE
DECORAH IA 52101

Officer/Director/Trustee Five

KAREN LARSON
DIRECTOR
45001 160TH STREET PO BOX 233
MABEL MN 55954-0233

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: Yes
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 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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