FORM 1023-EZ for SHAPESHIFT THEATRICAL INC

Field Data
EIN 47-4115926
Case Number EO-2015152-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHAPESHIFT THEATRICAL INC
Organization’s Mailing Address 500 WASHINGTON AVENUE SOUTH
City MINNEAPOLIS
State MN
ZIP 55415-1134
Accounting period End 12
Primary contact name MARC BERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ADRIA MCKINLEY
DIRECTOR
6936 EWING AVENUE NORTH
BROOKLYN CENTER MN 55429-1438

Officer/Director/Trustee Two

TIM REARDON
DIRECTOR
4817 GLENWOOD AVENUE
GOLDEN VALLEY MN 55422-5114

Officer/Director/Trustee Three

LOUIS TAYLOR
DIRECTOR
7024 KENMARE DRIVE
BLOOMINGTON MN 55438-2832

Officer/Director/Trustee Four

ASHLEY SELMER
PRESIDENT
432 NORTH FIRST STREET
MINNEAPOLIS MN 55401-1386

Officer/Director/Trustee Five

MARC BERG
SECRETARY
500 WASHINGTON AVENUE SOUTH
MINNEAPOLIS MN 55415-1134

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/28/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A62 - Dance
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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