FORM 1023-EZ for DODGE COUNTY 4-H AGRICULTURAL SOCIETY

Field Data
EIN 47-0619400
Case Number EO-2014233-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DODGE COUNTY 4-H AGRICULTURAL SOCIETY
Organization’s Mailing Address PO BOX 182
City FREMONT
State NE
ZIP 68026-0182
Accounting period End 10
Primary contact name STEVEN E PRIBNOW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEVIN PRINZ
PRESIDENT
PO BOX 1268
FREMONT NE 68026-1268

Officer/Director/Trustee Two

NICK PETERSEN
VICE PRESIDENT
1663 CO RD 17
FREMONT NE 68025

Officer/Director/Trustee Three

JAY SCHROEDER
GENERAL FAIR CHAIRMAN
2450 BUSINESS PARK DR
FREMONT NE 68025

Officer/Director/Trustee Four

JAHN GRANDSTAFF
DIRECTOR
PO BOX 549
FREMONT NE 68026-0549

Officer/Director/Trustee Five

CHRIS MENN
DIRECTOR
849 N I ST
FREMONT NE 68025

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/1978
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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