FORM 1023-EZ for USA BROOMBALL - MINNESOTA WOMEN

Field Data
EIN 47-4807974
Case Number EO-2015240-000319
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name USA BROOMBALL - MINNESOTA WOMEN
Organization’s Mailing Address 2330 COUNTY ROAD F E
City WHITE BEAR LAKE
State MN
ZIP 55110-7402
Accounting period End 12
Primary contact name ANN M FLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KIM NIEDERLUECKE
CHAIR
14205 DEARBORN PATH
ROSEMOUNT MN 55068-4527

Officer/Director/Trustee Two

LISA SPANNBAUER
VICE CHAIR, STRATEGY
1439 IVY AVENUE EAST
SAINT PAUL MN 55106-2105

Officer/Director/Trustee Three

AMY ANDERSON
VICE CHAIR, DEVELOPMENT
2330 COUNTY ROAD F E
WHITE BEAR LAKE MN 55110-7402

Officer/Director/Trustee Four

ANN FLIS
VICE CHAIR, GOAL SPECIALIST
2330 COUNTY ROAD F E
WHITE BEAR LAKE MN 55110-7402

Officer/Director/Trustee Five

CHERYL PEXA
TREASURER
14205 DEARBORN PATH
ROSEMOUNT MN 55064-4527

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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