FORM 1023-EZ for SARA ROSE HOUGOM FOUNDATION

Field Data
EIN 47-5014477
Case Number EO-2021250-000360
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SARA ROSE HOUGOM FOUNDATION
Organization’s Mailing Address W2887 KLOSS RD
City LACROSSE
State WI
ZIP 54601
Accounting period End 12
Primary contact name SHERRY HOUGOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERRY HOUGOM
PRESIDENT
W2887 KLOSS RD
LACROSSE WI 54601

Officer/Director/Trustee Two

RANDY PETERSON
TREASURER
W2887 KLOSS RD
LACROSSE WI 54601

Officer/Director/Trustee Three

TIMOTHY HOUGOM
VICE PRESIDENT
810 16TH STREET
LACROSSE WI 54601

Officer/Director/Trustee Four

DANA ZABEL
SECRETARY
E 3406 US HIGHWAY 14
COON VALLEY WI 54623

Officer/Director/Trustee Five

SCOTT HOGAN
DIRECTOR
4292 GADWALL COURT
EAGAN MN 55122

Organization’s website
Organization’s email SHOUGOM1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHERRY HOUGOM
Signature Title PRESIDENT
Signature Date 9/3/2021
EIN 47-5014477
Case Number EO-2015301-000185
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SARA ROSE HOUGOM FOUNDATION
Organization’s Mailing Address W2887 KLOSS RD
City LA CROSSE
State WI
ZIP 54601
Accounting period End 12
Primary contact name LOGAN TATE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHERRY HOUGOM
PRESIDENT
W2887 KLOSS ROAD
LA CROSSE WI 54601

Officer/Director/Trustee Two

RANDY PETERSON
VICE PRESIDENT
W2887 KLOSS ROAD
LA CROSSE WI 54601

Officer/Director/Trustee Three

TIMOTHY HOUGOM
SECRETARY
810 16TH ST SOUTH
LA CROSSE WI 54601

Officer/Director/Trustee Four

KEVAN KENT
TREASURER
1531 FLAT ROAD
HOLMEN WI 54636

Officer/Director/Trustee Five

LOGAN TATE
FOUNDER
430 N 9TH ST
LA CROSSE WI 54601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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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