FORM 1023-EZ for SOUTHEAST IOWA SWIM CLUB INC

Field Data
EIN 81-4361946
Case Number EO-2016355-000122
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTHEAST IOWA SWIM CLUB INC
Organization’s Mailing Address 2221 OSBORN STREET
City BURLINGTON
State IA
ZIP 52601
Accounting period End 12
Primary contact name MELINDA HENTZEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE ABOUASSALY
PRESIDENT, DIRECTOR
830 MONTICELLO DRIVE
BURLINGTON IA 52601

Officer/Director/Trustee Two

MELINDA HENTZEL
TREASURER, DIRECTOR
2221 OSBORN STREET
BURLINGTON IA 52601

Officer/Director/Trustee Three

JOHN FRUEHLING
VICE PRESIDENT, DIRECTOR
6093 MADISON AVENUE
BURLINGTON IA 52601

Officer/Director/Trustee Four

AMY DASCHER
SECRETARY, DIRECTOR
2656 NEBRASKA AVENUE
MT PLEASANT IA 52641

Officer/Director/Trustee Five

CORTNEY CURRY
DIRECTOR
2500 SUNNYSIDE AVENUE
BURLINGTON IA 52601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2016
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
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 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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