FORM 1023-EZ for FAITH ROSE 5K

Field Data
EIN 81-2203139
Case Number EO-2016105-000344
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAITH ROSE 5K
Organization’s Mailing Address 912 GENES RD SE
City ALEXANDRIA
State MN
ZIP 56308
Accounting period End 12
Primary contact name MARIA LOPAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARIA LOPAU
PRESIDENT
912 GENES RD SE
ALEXANDRIA MN 56308

Officer/Director/Trustee Two

HEIDI CIEPIELINSKI
VICE PRESIDENT
110 EAST OAK STREET
OSAKIS MN 56360

Officer/Director/Trustee Three

SARAH ROERS
TREASURER
10429 COUNTY ROAD 7 NW
BRANDON MN 56315

Officer/Director/Trustee Four

PATIA JENSEN
SECRETARY
17847 NORTH PELICAN LAKE ROAD
GLENWOOD MN 56334

Officer/Director/Trustee Five

KRISTIN OSTLUND
VICE TREASURER
3090 N OAKS LN NW
GARFIELD MN 56332

Organization’s website HTTP://FAITHROSE5K.WIX.COM/FAITHROSE5K
Organization’s email FAITHROSE5K@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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
Signature Title
Signature Date

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