FORM 1023-EZ for FIRST IN UPPER MIDWEST INC

Field Data
EIN 83-1918481
Case Number EO-2019031-000112
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FIRST IN UPPER MIDWEST INC
Organization’s Mailing Address 11036 GLEN WILDING LN
City BLOOMINGTON
State MN
ZIP 55431
Accounting period End 6
Primary contact name STEVE PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVEN PETERSON
CHAIR
11036 GLEN WILDING LN
BLOOMINGTON MN 55431

Officer/Director/Trustee Two

GENE JASPER
TREASURER
12825 34TH AVE N
PLYMOUT MN 55441

Officer/Director/Trustee Three

LAURIE SHIMIZU
DIRECTOR
6701 HILLSIDE LN
EDINA MN 55439

Officer/Director/Trustee Four

MARK LAWRENCE
DIRECTOR
6508 PARNELL AVE
EDINA MN 55435

Officer/Director/Trustee Five

JANE PETERSON
VICE CHAIR
1473 ROCKY LN
EAGAN MN 55122

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
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 STEVEN PETERSON
Signature Title CHAIR
Signature Date 1/6/19

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