FORM 1023-EZ for TWIN CITIES ADAPTIVE CYCLING

Field Data
EIN 81-5315931
Case Number EO-2017069-000291
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TWIN CITIES ADAPTIVE CYCLING
Organization’s Mailing Address 5117 JAMES AVE S
City MINNEAPOLIS
State MN
ZIP 55419
Accounting period End 12
Primary contact name CAITO BOWLES-ROTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FRANK VARDEMAN
PRESIDENT
2544 29TH AVE SOUTH
MINNEAPOLIS MN 55406

Officer/Director/Trustee Two

JOHN COX
TREASURER
N 13468 450TH ST
WHEELER WI 54772

Officer/Director/Trustee Three

SUSAN MUSKAT
BOARD MEMBER
2312 4TH AVE NORTH
MINNEAPOLIS MN 55405

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2017
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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
Signature Title
Signature Date

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