FORM 1023-EZ for BIG LAKE HS BOYS SOCCER BOOSTER CLUB

Field Data
EIN 87-2414421
Case Number EO-2021272-000221
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BIG LAKE HS BOYS SOCCER BOOSTER CLUB
Organization’s Mailing Address 1195 HIGHLAND BAY
City BIG LAKE
State MN
ZIP 55309
Accounting period End 12
Primary contact name CARLA ZIEMBO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLA KAY ZIEMBO
PRESIDENT
1195 HIGHLAND BAY
BIG LAKE MN 55309

Officer/Director/Trustee Two

KAREN PRIEST
SECRETARY
20042 DELTA STREET
BIG LAKE MN 55309

Officer/Director/Trustee Three

JOANNA MAUCH
VICE-PRESIDENT
549 KAREN LANE
BIG LAKE MN 55309

Officer/Director/Trustee Four

AMY BRUTGER-GERWING
TREASURER
5240 RUDDYDUCK LANE
BIG LAKE MN 55309

Organization’s website
Organization’s email BLBOYSSOCCER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 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 CARLA KAY ZIEMBO
Signature Title PRESIDENT
Signature Date 9/27/2021

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