FORM 1023-EZ for TEAM 2472 CENTENNIAL ROBOTICS

Field Data
EIN 87-1118890
Case Number EO-2021172-000096
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM 2472 CENTENNIAL ROBOTICS
Organization’s Mailing Address PO BOX 171
City CIRCLE PINES
State MN
ZIP 55014-0171
Accounting period End 12
Primary contact name CURTIS THEIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CURTIS THEIS
PRESIDENT
67 WEST RD
CIRCLE PINES MN 55014-1670

Officer/Director/Trustee Two

TERESA MICHELSON
TREASURER
4101 97TH LANE NE
BLAINE MN 55014-2425

Officer/Director/Trustee Three

KELLY SCHULTZ
SECRETARY
178 SHETLAND LANE
LINO LAKES MN 55014-5516

Organization’s website
Organization’s email CENTENNIALROBOTICSBOOSTER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/14/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: No
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CURTIS THEIS
Signature Title PRESIDENT
Signature Date 6/16/2021

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