FORM 1023-EZ for GREENDALE STEP UP TO BETTER HEALTH

Field Data
EIN 82-1386014
Case Number EO-2017142-000578
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GREENDALE STEP UP TO BETTER HEALTH
Organization’s Mailing Address 5650 PARKING ST
City GREENDALE
State WI
ZIP 53129-1836
Accounting period End 11
Primary contact name ALEKSANDER SKIBICKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALEKSANDER SKIBICKI
DIRECTOR
4256 TEAKWOOD CT
GREENDALE WI 53129-2635

Officer/Director/Trustee Two

DIANE THIEME
DIRECTOR
3033 N NEWHALL
MILWAUKEE WI 53211-3227

Officer/Director/Trustee Three

KERRY OWENS BURR
DIRECTOR
513 MANDAN DR
WAUKESHA WI 53188-4667

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/19/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
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 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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