FORM 1023-EZ for MADISON WORKERS COOPERATIVE

Field Data
EIN 46-1361962
Case Number EO-2019190-000291
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MADISON WORKERS COOPERATIVE
Organization’s Mailing Address 4211 SCHOOL ROAD
City MADISON
State WI
ZIP 53704
Accounting period End 12
Primary contact name ATTORNEY DAVID R SPARER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OLE OLSON
PRESIDENT
520 CHERRYWOOD DRIVE
OREGON WI 53575

Officer/Director/Trustee Two

KIM GRVELES
TREASURER
364 ELM STREET
MILTON WI 53563

Officer/Director/Trustee Three

MARTHA KEMBLE
SECRETARY
4211 SCHOOLS ROAD
MADISON WI 53704

Officer/Director/Trustee Four

DENNIS MCKERNAN
BOARD MEMBER
136 SPRUCE STREET
MINERAL POINT WI 53565

Officer/Director/Trustee Five

STEVE HERRICK
BOARD MEMBER
2929 UNION STREET
MADISON WI 53704

Organization’s website MADWORC.ORG
Organization’s email MADWORC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/12
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J01 - Alliance/Advocacy Organizations
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 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 OLE OLSON
Signature Title PRESIDENT
Signature Date 7/5/19

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