FORM 1023-EZ for BOOZEFIGHTERS MOTORCYCLE CLUB CHAPTER 193

Field Data
EIN 46-4994809
Case Number EO-2015191-000204
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BOOZEFIGHTERS MOTORCYCLE CLUB CHAPTER 193
Organization’s Mailing Address 225 TEXAS AVE
City WHITEFISH
State MT
ZIP 59937
Accounting period End 12
Primary contact name DAN JACOBSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AL DERBER
PRESIDENT
PO BOX 7104
BIGFORK MT 59911

Officer/Director/Trustee Two

MARK MCCONNAUGHEY
SECRETARY
PO BOX 10655
KALISPELL MT 55904

Officer/Director/Trustee Three

DAN JACOBSON
TREASURER
225 TEXAS AVE
WHITEFISH MT 59937

Officer/Director/Trustee Four

MATHEW KIREILIS
SARGEANT OF ARMS
430 E 3RD ST
WHITEFISH MT 59937

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2014
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - 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 Yes
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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