FORM 1023-EZ for CHOSEN FAMILY MKE INC

Field Data
EIN 85-2049132
Case Number EO-2020224-000541
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHOSEN FAMILY MKE INC
Organization’s Mailing Address 12721 W LANCASTER AVE
City BUTLER
State WI
ZIP 53007
Accounting period End 12
Primary contact name AMY HAYNES COE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY HAYNES COE
PRESIDENT, DIRECTOR
12721 W LANCASTER AVE
BUTLER WI 53007

Officer/Director/Trustee Two

SAMUEL HAYNES
TREASURER
12721 W LANCASTER AVE
BUTLER WI 53007

Officer/Director/Trustee Three

SABRINA KENT
CHAIRPERSON OF THE GOVERNING BODY,
4035 S 65TH APARTMENT 1
GREENFIELD WI 53220

Officer/Director/Trustee Four

ANTHONY PRIEBE
SECRETARY
1505 N FRANKLIN PLACE APT 601
MILWAUKEE WI 53202

Officer/Director/Trustee Five

CHAD TREPANIER
DIRECTOR
4035 S 65TH APARTMENT 1
GREENFIELD WI 53220

Organization’s website
Organization’s email OFFICE@CHOSENFAMILYMKE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/20/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 AMY HAYNES COE
Signature Title PRESIDENT, DIRECTOR
Signature Date 8/7/2020

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