FORM 1023-EZ for KEY CITY SOCCER ASSOCIATION

Field Data
EIN 38-3992070
Case Number EO-2019246-000103
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KEY CITY SOCCER ASSOCIATION
Organization’s Mailing Address 85 FREMONT AVE
City DUBUQUE
State IA
ZIP 52003
Accounting period End 12
Primary contact name DAN ROTHERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAN ROTHERT
PRESIDENT
85 FREMONT AVE
DUBUQUE IA 52003

Officer/Director/Trustee Two

JIM NAPRSTEK
VICE PRESIDENT
85 FREMONT AVE
DUBUQUE IA 52003

Officer/Director/Trustee Three

TRENT HANSELMAN
MEDIA
85 FREMONT AVE
DUBUQUE IA 52003

Organization’s website WWW.KEYCITYSOCCER.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/15/16
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAN ROTHERT
Signature Title PRESIDENT
Signature Date 8/29/19

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