FORM 1023-EZ for LIFE AFTER SERVICE

Field Data
EIN 84-4996511
Case Number EO-2021120-000281
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFE AFTER SERVICE
Organization’s Mailing Address 142 E SCHLIEMAN
City APPLETON
State MN
ZIP 56208
Accounting period End 12
Primary contact name QUINTON LH0TKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

QUINTON LHOTKA
BOARD CHAIR
142 E SCHLIEMAN
APPLETON MN 56208

Officer/Director/Trustee Two

JEREMY OSTERAAS
VICE CHAIR
321 EAST 6TH STREET
MADISON MN 56256

Officer/Director/Trustee Three

JAKE THELL
SERGEANT AT ARMS
2888 HWY 75
BELLINGHAM MN 56212

Officer/Director/Trustee Four

MICHELLE OVERHOLSER
SECRETARY
212 NORTH 2ND ST
MILAN MN 56262

Officer/Director/Trustee Five

BEN DOLAN
TREASURER
324 EAST SNELLING
APPLETON MN 56208

Organization’s website WWW.LIVESAFTERSERVICE.COM
Organization’s email LAS.LIFEAFTERSERVICE@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - 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 Yes
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 QUINTON LHOTKA
Signature Title BOARD CHAIR
Signature Date 4/29/2021

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