FORM 1023-EZ for FITNESS-WAYLAND

Field Data
EIN 82-2323759
Case Number EO-2017228-000389
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FITNESS-WAYLAND
Organization’s Mailing Address 208 W MAIN ST
City WAYLAND
State IA
ZIP 52654
Accounting period End 6
Primary contact name DEB ROTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEB ROTH
PRESIDENT
1354 DAKOTA AVE
WAYLAND IA 52654

Officer/Director/Trustee Two

MARTHA WIDMER
VP
1118 HWY 78
WAYLAND IA 52654

Officer/Director/Trustee Three

LORI MESSER
SECRETARY
207 W DEPOT
WAYLAND IA 52654

Officer/Director/Trustee Four

KATHLEEN GLASS
TREASURER
1187 140TH STREET
WAYLAND IA 52654

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/2017
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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