FORM 1023-EZ for WISCONSIN DISASTER MEDICAL RESPONSETEAM INC

Field Data
EIN 82-2357179
Case Number EO-2018089-000372
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WISCONSIN DISASTER MEDICAL RESPONSETEAM INC
Organization’s Mailing Address 1535 N ELM STREET
City PLATTEVILLE
State WI
ZIP 53818
Accounting period End 12
Primary contact name IRV LUPEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IRV LUPEE
PRESIDENT
1535 N ELM STREET
PLATTEVILLE WI 53818

Officer/Director/Trustee Two

ROXANNE RICHARDS
TREASURER
449 GALE DRIVE
WISCONSIN DELLS WI 53965-9002

Officer/Director/Trustee Three

BRUCE HANNIGAN
SECRETARY
4416 N MARSHALL HEIGHTS AVENUE
APPLETON WI 54913-7175

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/17
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M20 - Disaster Preparedness and Relief Services
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 Yes
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 IRV LUPEE
Signature Title PRESIDENT
Signature Date 3/28/18

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