FORM 1023-EZ for BIG MARINE LAKE ASSOCIATION

Field Data
EIN 27-2868593
Case Number EO-2015163-000036
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BIG MARINE LAKE ASSOCIATION
Organization’s Mailing Address 3408 UTAH AVENUE NORTH
City CRYSTAL
State MN
ZIP 55427
Accounting period End 12
Primary contact name RICHARD BURTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL BLEHERT
PRESIDENT
3408 UTAH AVENUE NORTH
CRYSTAL MN 55427

Officer/Director/Trustee Two

RICHARD BURTON
VICE PRESIDENT
12624-182ND STREET NORTH
MARINE MN 55047

Officer/Director/Trustee Three

DOUGLAS SALMELA
TREASURER
19101 LAYTON AVENUE NORTH
MARINE MN 55047

Officer/Director/Trustee Four

JEFF DAHLBERG
SURVEY LEAD
19151 LAYTON AVENUE NORTH
MARINE MN 55047

Officer/Director/Trustee Five

TONY VAVOULIS
MEMBER AT LARGE
740 LINWOOD AVENUE
ST. PAUL MN 55105

Organization’s website
Organization’s email RICHARDBURTONMN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/16/2010
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C99 - Environmental Quality, Protection, and Beautification N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
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
Signature Title
Signature Date

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