FORM 1023-EZ for BLAINE COUNTY FAIR FOUNDATION

Field Data
EIN 81-4663409
Case Number EO-2017055-000677
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLAINE COUNTY FAIR FOUNDATION
Organization’s Mailing Address 11105 WESTFORK RD
City CHINOOK
State MT
ZIP 59523
Accounting period End 12
Primary contact name DALE L WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DALE L WILLIAMS
CHAIRMAN
11105 WESTFORK RD
CHINOOK MT 59523

Officer/Director/Trustee Two

JOHN SKOYEN
VICE CHAIRMAN
425 SUN SET LN
CHINOOK MT 59523

Officer/Director/Trustee Three

LAURA KLEINJAN
SECRETARY/TREASURER
195 VALLEY VIEW LN
CHINOOK MT 59523

Officer/Director/Trustee Four

DON RICHMAN
DIRECTOR
204 2ND STR SE
HARLEM MT 59526

Officer/Director/Trustee Five

LOREN SKOYEN
DIRECTOR
355 LODGE CREEK RD
CHINOOK MT 59523

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2016
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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