FORM 1023-EZ for MINNESOTA LAKE VOLUNTEER AMBULANCERELIEF ASSOCIATION

Field Data
EIN 83-3345600
Case Number EO-2021100-000785
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MINNESOTA LAKE VOLUNTEER AMBULANCERELIEF ASSOCIATION
Organization’s Mailing Address PO BOX 112
City MINNESOTA LAKE
State MN
ZIP 56068
Accounting period End 12
Primary contact name DAWN M WHITEHEAD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINA BOERTJE
PRESIDENT
52644 205TH ST
MINNESOTA LAKE MN 56068

Officer/Director/Trustee Two

DAWN SONNEK
SECRETARY/TREASURER
PO BOX 277
MINNESOTA LAKE MN 56068

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/4/2019
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E62 - Ambulance, Emergency Medical Transport Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
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 CHRISTINA BOERTJE
Signature Title PRESIDENT
Signature Date 3/26/2021

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