FORM 1023-EZ for TEAM KOPACZ INC

Field Data
EIN 83-0687319
Case Number EO-2019157-000250
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM KOPACZ INC
Organization’s Mailing Address 1290 MEADOW CT
City SHOREVIEW
State MN
ZIP 55126
Accounting period End 12
Primary contact name JASON KOPACZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON KOPACZ
PRESIDENT
1290 MEADOW COURT
SHOREVIEW MN 55126

Officer/Director/Trustee Two

WILLIAM OCONNELL
TREASURER
6132 146TH AVE NW
RAMSEY MN 55303

Officer/Director/Trustee Three

ANNE HAIGHT
DIRECTOR
3615 INGLEWOOD AVE SOUTH
ST LOUIS PARK MN 55416

Officer/Director/Trustee Four

KERRY GAUTSCH
DIRECTOR
12431 PINEWOOD WAY N
DAYTON MN 55327

Officer/Director/Trustee Five

LINN WARNKE
DIRECTOR
2208 GIRARD AVE SOUTH UNIT 1
MINNEAPOLIS MN 55405

Organization’s website WWW.TEAMKOPACZ.COM
Organization’s email JASONKOPACZ@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/14/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H96 - Neurology, Neuroscience Research
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 JASON KOPACZ
Signature Title PRESIDENT
Signature Date 6/4/19

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