FORM 1023-EZ for TAKE BACK BRIDGEWATER IOWA

Field Data
EIN 82-0742476
Case Number EO-2017128-000031
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TAKE BACK BRIDGEWATER IOWA
Organization’s Mailing Address 201 NW 3RD STREET
City BRIDGEWATER
State IA
ZIP 50837
Accounting period End 12
Primary contact name DOUGLAS MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS MILLER
PRESIDENT
201 NW 3RD STREET
BRIDGEWATER IA 50837

Officer/Director/Trustee Two

DENEISE OLSON
SECRETARY
201 NW 3RD STREET
BRIDGEWATER IA 50837

Officer/Director/Trustee Three

JUDY FORD
TREASURER
201 NW 3RD STREET
BRIDGEWATER IA 50837

Organization’s website HTTPS://WWW.FACEBOOK.COM/TAKEBACKBRIDGEWATERIOWA/
Organization’s email TAKEBACKBRIDGEWATERIOWA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/2017
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I20 - Crime Prevention 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 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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