FORM 1023-EZ for JOHN CLUB 1609 GROUP

Field Data
EIN 30-0454420
Case Number EO-2019042-000092
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JOHN CLUB 1609 GROUP
Organization’s Mailing Address 1609 JOHN AVE
City SUPERIOR
State WI
ZIP 54880-2614
Accounting period End 12
Primary contact name BRENDA ROYER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRENDA ROYER
TREASURER
3545 HAINES RD
HERMANTOWN MN 55811-3758

Officer/Director/Trustee Two

SHERRY NORD
SECRETARY
2703 E 3RD ST
SUPERIOR WI 54880-3909

Officer/Director/Trustee Three

CLYDE ROYER
CHAIRMAN
3545 HAINES RD
HERMANTOWN MN 55811-3758

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/26/07
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRENDA ROYER
Signature Title TREASURER
Signature Date 2/7/19

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