FORM 1023-EZ for NORTH DAKOTA 1752 CLUB

Field Data
EIN 84-3960417
Case Number EO-2019351-000027
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH DAKOTA 1752 CLUB
Organization’s Mailing Address 3669 22ND ST S
City FARGO
State ND
ZIP 58104
Accounting period End 12
Primary contact name KIM BERGESON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIM BERGESON
PRESIDENT
3669 22ND ST S
FARGO ND 58104

Officer/Director/Trustee Two

VICKI CARLSON
SECRETARY/TREASURER
3551 WOODBURY PARK DR S
FARGO ND 58103

Officer/Director/Trustee Three

GAIL SEVERINSON
VICE PRESIDENT
PO BOX 48
COTTONWOOD MN 56229

Officer/Director/Trustee Four

MICHAEL HARTMAN
DIRECTOR
4125 GREAT PLAINS DRIVE S
FARGO ND 58104

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/2019
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 KIM BERGESON
Signature Title PRESIDENT
Signature Date 12/12/2019

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