FORM 1023-EZ for BOREALIS HOLISTICS MINISTRY LTD

Field Data
EIN 82-0923018
Case Number EO-2017086-000342
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BOREALIS HOLISTICS MINISTRY LTD
Organization’s Mailing Address W561 STATE HIGHWAY 70
City PARK FALLS
State WI
ZIP 54552-7236
Accounting period End 3
Primary contact name LARRY KINNETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARRY KINNETT
BOARD MEMBER
W561 STATE HIGHWAY 70
PARK FALLS WI 54552-7236

Officer/Director/Trustee Two

NANCY KINNETT
BOARD MEMBER
W561 STATE HIGHWAY 70
PARK FALLS WI 54552-7236

Officer/Director/Trustee Three

RICHARD JACK
BOARD MEMBER
3071 CEMETERY RD
LAC DU FLAMBEAU WI 54538

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: No
Religious: Yes
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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