FORM 1023-EZ for MOUNTAIN LAKE SOCCER

Field Data
EIN 38-3749186
Case Number EO-2017163-000233
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNTAIN LAKE SOCCER
Organization’s Mailing Address PO BOX 478
City MOUNTAIN LAKE
State MN
ZIP 56159
Accounting period End 12
Primary contact name MICHAEL JAMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALLISON KLASSEN
PRESIDENT
55617 COUNTY ROAD 13
MOUNTAIN LAKE MN 56159

Officer/Director/Trustee Two

MICHAEL JAMES
TREASURER
56860 LAKESHORE DRIVE
MOUNTAIN LAKE MN 56159

Officer/Director/Trustee Three

DANIEL BARGEN
DIRECTOR
216 12TH STREET S
MOUNTAIN LAKE MN 56159

Officer/Director/Trustee Four

JOELLE BARGEN
DIRECTOR
216 12TH STREET S
MOUNTAIN LAKE MN 56159

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2006
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 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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