FORM 1023-EZ for FOND DU LAC COUNTY YOUTH ARCHERY CLUB

Field Data
EIN 82-1991779
Case Number EO-2019086-000561
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOND DU LAC COUNTY YOUTH ARCHERY CLUB
Organization’s Mailing Address PO BOX 205
City FOND DU LAC
State WI
ZIP 54936-205
Accounting period End 4
Primary contact name DANA ROEHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHNNY HERBECK
PRESIDENT
25 ROBERTS CT
FOND DU LAC WI 54935

Officer/Director/Trustee Two

STEVE WIRTZ
VICE PRESIDENT
N6334 TOWER RD
FOND DU LAC WI 54937

Officer/Director/Trustee Three

ANGELA NYBACK
SECRETARY
483 TEMPERANCE ST
FOND DU LAC WI 54937

Officer/Director/Trustee Four

DANA ROEHL
TREASURER
78 S ROYAL AVE
FOND DU LAC WI 54935

Organization’s website
Organization’s email FDLARCHERY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/15
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 DANA ROEHL
Signature Title TREASURER
Signature Date 3/25/19

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