FORM 1023-EZ for PEPIN COUNTY ATVUTV CLUB INC

Field Data
EIN 46-5266977
Case Number EO-2018334-000314
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PEPIN COUNTY ATVUTV CLUB INC
Organization’s Mailing Address W9579 CEDAR DRIVE
City PEPIN
State WI
ZIP 54759
Accounting period End 6
Primary contact name VICTOR KOMISAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VICTOR KOMISAR
PRESIDENT
W9502 BALSAM LANE
PEPIN WI 54759

Officer/Director/Trustee Two

JASON UNSER
VICE PRESIDENT
N4765 PORCUPINE ROAD
ARKANSAW WI 54721

Officer/Director/Trustee Three

DUSTIN GOLD
TREASURE
W9579 CEDAR DRIVE
PEPIN WI 54759

Officer/Director/Trustee Four

LINDA KOMRO
SECRETARY
W9228 WEBER ROAD
ARKANSAW WI 54721

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/27/14
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 VICTOR KOMISAR
Signature Title PRESIDENT
Signature Date 11/28/18

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