FORM 1023-EZ for LAKE COOPER FOUNDATION

Field Data
EIN 46-5696486
Case Number EO-2014328-000378
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE COOPER FOUNDATION
Organization’s Mailing Address 728 FRANKLIN STREET
City KEOKUK
State IA
ZIP 52632
Accounting period End 12
Primary contact name ROBERT KORSCHGEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT KORSCHGEN
PRESIDENT, DIRECTOR
728 FRANKLIN ST
KEOKUK IA 52632

Officer/Director/Trustee Two

DOUG MATLICK
VICE PRESIDENT, DIRECTOR
718 GRAND AVE
KEOKUK IA 52632

Officer/Director/Trustee Three

THOMAS BELL
SECRETARY, DIRECTOR
440 SOUTH 13TH STREET
KEOKUK IA 52632

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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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