FORM 1023-EZ for CLUB CONNECT

Field Data
EIN 83-2481027
Case Number EO-2019273-000213
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLUB CONNECT
Organization’s Mailing Address 8524 W 132ND ST
City SAVAGE
State MN
ZIP 55378
Accounting period End 12
Primary contact name HEATHER GOSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEATHER GOSEN
CHIEF EXECUTIVE OFFICER
8524 W 132ND ST
SAVAGE MN 55378

Officer/Director/Trustee Two

IAN GRAMACCIONI
PRESIDENT
7744 STAFFORD TRAIL
SAVAGE MN 55378

Officer/Director/Trustee Three

ANDREW GOSEN
VICE PRESIDENT
8524 W 132ND ST
SAVAGE MN 55378

Organization’s website HTTP://WWW.CLUBCONNECTMN.ORG
Organization’s email ADMIN@CLUBCONNECTMN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HEATHER GOSEN
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 9/26/19

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