FORM 1023-EZ for BLAINE HIGH SCHOOL ROBOTICS ASSOCIATION

Field Data
EIN 82-1521072
Case Number EO-2017289-000564
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLAINE HIGH SCHOOL ROBOTICS ASSOCIATION
Organization’s Mailing Address 12555 UNIVERSITY AVE NE
City BLAINE
State MN
ZIP 55434
Accounting period End 6
Primary contact name ALEXANDER ZEITLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALEXANDER ZEITLER
PRESIDENT
13232 MANKATO ST NE
BLAINE MN 55449

Officer/Director/Trustee Two

DANIEL JENTGES
VICE PRESIDENT
14365 ZILLA STREET
ANDOVER MN 55304

Officer/Director/Trustee Three

VERONICA FROSCH
TREASURER
11642 YUKON ST NW
COON RAPIDS MN 55433

Officer/Director/Trustee Four

DEANA WEYER
SECRETARY
362 NATHAN LN N
CHAMPLIN MN 55316

Organization’s website
Organization’s email ROBOBOOSTERS2181@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2017
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: 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 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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