FORM 1023-EZ for CHIPPEWA PHEASANTS INC

Field Data
EIN 86-3670179
Case Number EO-2021260-000041
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHIPPEWA PHEASANTS INC
Organization’s Mailing Address 222 S 8TH ST
City MONTEVIDEO
State MN
ZIP 56265
Accounting period End 12
Primary contact name JEREMY PAULING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEREMY PAULING
PRESIDENT & DIRECTOR
1433 RIDGEVIEW DR
MONTEVIDEO MN 56265

Officer/Director/Trustee Two

TOM BRUSVEN
TREASURER & DIRECTOR
222 S 8TH ST
MONTEVIDEO MN 56265

Officer/Director/Trustee Three

PAUL CARLSON
SECRETARY & DIRECTOR
1025 90TH ST SW
MONTEVIDEO MN 56265

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C60 - Environmental Education and Outdoor Survival Programs
Organization’s purpose Charitable: No
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 Yes
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 JEREMY PAULING
Signature Title PRESIDENT & DIRECTOR
Signature Date 6/12/2021

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