FORM 1023-EZ for SONS OF NORWAY FIFTH DISTRICT NORDIC LEGACY FOUNDATION

Field Data
EIN 82-1124535
Case Number EO-2017103-000481
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SONS OF NORWAY FIFTH DISTRICT NORDIC LEGACY FOUNDATION
Organization’s Mailing Address 5747 SANDY LANE
City RACINE
State WI
ZIP 53406-2226
Accounting period End 12
Primary contact name MICHAEL PALECEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW JOHNSEN
PRESIDENT
11906 HAWTHORNE PLACE
CEDAR LAKE IN 46303-9363

Officer/Director/Trustee Two

KATHLEEN SECORA
VICE PRESIDENT
1410 WESTBURY DRIVE
HOFFMAN ESTATES IL 60192-1347

Officer/Director/Trustee Three

DARLENE ARNESON
SECRETARY
2056 SKAALEN ROAD
STOUGHTON WI 53589-3530

Officer/Director/Trustee Four

MICHAEL PALECEK
TREASURER
5747 SANDY LANE
RACINE WI 53406-2226

Officer/Director/Trustee Five

CHERYL WILLE-SCHLESSER
MEMBER AT LARGE
200 BETH CIRCLE
MOUNT HOREB WI 53572-1645

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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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