FORM 1023-EZ for ROOTS

Field Data
EIN 84-2058834
Case Number EO-2019165-000162
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROOTS
Organization’s Mailing Address 2822 3RD AVENUE
City KEARNEY
State NE
ZIP 68845
Accounting period End 12
Primary contact name KARAH MASCHMEIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KARAH MASCHMEIER
PRESIDENT/TREASURER/DIRECTOR
2822 3RD AVENUE
KEARNEY NE 68845

Officer/Director/Trustee Two

ELISE KLEIN
VICE PRESIDENT/SECRETARY/DIRECTOR
820 WEST 56TH STREET APARTMENT 171
KEARNEY NE 68845

Officer/Director/Trustee Three

BRIAN SYMINGTON
DIRECTOR
3935 11TH AVENUE
KEARNEY NE 68845

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/19
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 BRIAN SYMINGTON
Signature Title DIRECTOR
Signature Date 6/12/19

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