FORM 1023-EZ for BARABOO BLUE LINE CLUB INC

Field Data
EIN 45-5158429
Case Number EO-2020265-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BARABOO BLUE LINE CLUB INC
Organization’s Mailing Address PO BOX 410
City BARABOO
State WI
ZIP 53913
Accounting period End 12
Primary contact name DONALD CONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TOM FITZWILLIAMS
PRESIDENT/TREASURER
127 10TH AVE
BARABOO WI 53913

Officer/Director/Trustee Two

DONALD CONE
VICE PRESIDENT
2247 REINHARDT CT
REEDSBURG WI 53959

Officer/Director/Trustee Three

SEAN COLLINS
SECRETARY
1606 AMERY DRIVE
BARABOO WI 53913

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2013
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: No
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 Yes
Correctness Declaration Yes
Signature Name DONALD CONE
Signature Title VICE PRESIDENT
Signature Date 9/17/2020

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