FORM 1023-EZ for BASS LAKE CLEAN WATER COALITION

Field Data
EIN 83-3339982
Case Number EO-2019038-000007
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BASS LAKE CLEAN WATER COALITION
Organization’s Mailing Address 5555 THREE POINTS BLVD
City MOUND
State MN
ZIP 55364-1154
Accounting period End 12
Primary contact name MARK HANSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK HANSON
OFFICER
5555 THREE POINTS BLVD
MOUND MN 55364-1154

Officer/Director/Trustee Two

TIM KELLY
OFFICER
270 N MONTGOMERY
LECENTER MN 56057

Officer/Director/Trustee Three

NONE NONE
NONE
NONE
NONE MN 55364-1154

Officer/Director/Trustee Four

NONE NONE
NONE
NONE
NONE MN 55364-1154

Officer/Director/Trustee Five

NONE NONE
NONE
NONE
NONE MN 55364-1154

Organization’s website BASSLAKECLEANWATER.ORG
Organization’s email SAVEBASSLAKE@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C32 - Water Resource, Wetlands Conservation and Management
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 MARK HANSON
Signature Title OFFICER
Signature Date 1/29/19

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