FORM 1023-EZ for GBBA USBC BA

Field Data
EIN 57-1236366
Case Number EO-2015035-000179
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GBBA USBC BA
Organization’s Mailing Address 240 OAK HILL DRIVE
City GREEN BAY
State WI
ZIP 54301-1823
Accounting period End 7
Primary contact name WAYNE H TESKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JERRY POLAREK
PRESIDENT
1377 SETTLERS ROW
GREEN BAY WI 54313

Officer/Director/Trustee Two

JOHN SCHMITZ
VICE-PRESIDENT
555 LORRAINE LANE
GREEN BAY WI 54311-5770

Officer/Director/Trustee Three

WAYNE TESKE
MANAGER
240 OAK HILL DRIVE
GREEN BAY WI 54301-1823

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2006
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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