FORM 1023-EZ for MAPLE PLACE INC

Field Data
EIN 83-0732313
Case Number EO-2018162-000480
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAPLE PLACE INC
Organization’s Mailing Address PO BOX 376
City LAONA
State WI
ZIP 54541
Accounting period End 12
Primary contact name PHILLIP ADAMCZYK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHILLIP ADAMCZYK
CHAIR / EXECUTIVE DIRECTOR
1778 CAVOUR AVENUE
WABENO WI 54566

Officer/Director/Trustee Two

RICHARD SCHAAL
VICE-CHAIR
14608 TAR DAM ROAD
MOUNTAIN WI 54149

Officer/Director/Trustee Three

HELEN SCHAAL
SECRETARY
14608 TAR DAM ROAD
MOUNTAIN WI 54149

Officer/Director/Trustee Four

JONEL CALHOUN
TREASURER
5034 EAST SILVER LAKE ROAD
LAONA WI 54541

Officer/Director/Trustee Five

KRISTOPHER TRYCZAK
DIRECTOR
1778 CAVOUR AVENUE
WABENO WI 54566

Organization’s website
Organization’s email MAPLEPLACELAONA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A82 -
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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PHILLIP ADAMCZYK
Signature Title CHAIR / EXECUTIVE DIRECTOR
Signature Date 6/9/18

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