FORM 1023-EZ for DAIRYLAND SPORTS CORPORATION

Field Data
EIN 82-3718737
Case Number EO-2018075-000077
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DAIRYLAND SPORTS CORPORATION
Organization’s Mailing Address 2781 CRINKLE ROOT DRIVE
City FITCHBURG
State WI
ZIP 53711
Accounting period End 12
Primary contact name JACOB GRABOSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH JENKS
PRESIDENT
430 ORCHARD DRIVE
OREGON WI 53575

Officer/Director/Trustee Two

JACOB GRABOSKI
VICE PRESIDENT AND TREASURER
2781 CRINKLE ROOT DRIVE
FITCHBURG WI 53711

Officer/Director/Trustee Three

MIKAYLA SCOTT
SECRETARY
288 NORTH MUSKET RIDGE COURT
SUN PRAIRIE WI 53590

Officer/Director/Trustee Four

BRANDON HOLSTEIN
COMMUNITY OUTREACH COORDINATOR
2914 KENTVILLE DRIVE
SUN PRAIRIE WI 53590

Officer/Director/Trustee Five

KARYN LAURSEN
MEDICAL OUTREACH COORDINATOR
LUCIA CREST
MADISON WI 53705

Organization’s website WWW.DAIRYLANDSPORTS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/8/17
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JACOB GRABOSKI
Signature Title VICE PRESIDENT AND TREASURER
Signature Date 3/14/18

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