FORM 1023-EZ for SHAKY PUTTER GOLF BENEFIT

Field Data
EIN 81-2419514
Case Number EO-2016131-000088
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHAKY PUTTER GOLF BENEFIT
Organization’s Mailing Address 7670 LANGLY AVE
City COTTAGE GROVE
State MN
ZIP 55016
Accounting period End 12
Primary contact name JAY SOCKNESS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAY SOCKNESS
PRESIDENT
7670 LANGLY AVE
COTTAGE GROVE MN 55016

Officer/Director/Trustee Two

MICHELE SOCKNESS
SECRETARY
7670 LANGLY AVE
COTTAGE GROVE MN 55016

Officer/Director/Trustee Three

STEFANO SALUTE
VICE-PRESIDENT
3074 CHISHOLM CT
MAPLEWOOD MN 55119

Officer/Director/Trustee Four

JILLIAN SMITH
TREASURER
6698 WILDFLOWER DR
COTTAGE GROVE MN 55016

Officer/Director/Trustee Five

JEFF DINGLE
BOARD MEMBER
7680 LANGLY AVE
COTTAGE GROVE MN 55016

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/27/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - Fund Raising and/or Fund Distribution
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 Yes
One Third Support Gifts No
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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