FORM 1023-EZ for LEADERSHIP WALWORTH

Field Data
EIN 46-4788748
Case Number EO-2016123-000338
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEADERSHIP WALWORTH
Organization’s Mailing Address 1556 ORCHARD LANE
City LAKE GENEVA
State WI
ZIP 53147
Accounting period End 10
Primary contact name EDGAR MOSSHAMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID FROST
PRESIDENT
1556 ORCHARD LANE
LAKE GENEVA WI 53147

Officer/Director/Trustee Two

EDGAR MOSSHAMER
TREASURER
27 CONSTANCE BLVD
WILLIAMS BAY WI 53191

Officer/Director/Trustee Three

DAVID BRETL
SECRETARY
100 W WALWORTH ST
ELKHORN WI 53121

Organization’s website
Organization’s email INFO@LEADERSHIPWALWORTH.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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