FORM 1023-EZ for MASSVAXX CORPORATION

Field Data
EIN 85-4191000
Case Number EO-2021033-000193
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MASSVAXX CORPORATION
Organization’s Mailing Address 330 EAST KILBOURN AVENUE SUITE 1017
City MILWAUKEE
State WI
ZIP 53202
Accounting period End 12
Primary contact name STEPHEN LASKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID FRALEY III
DIRECTOR
9604 WATTS ROAD APT 315
VERONA WI 53953

Officer/Director/Trustee Two

DANA COOK
DIRECTOR
6585 WEST DIVISION STREET
MEQUON WI 53092

Officer/Director/Trustee Three

PETER HOGYA
DIRECTOR
1218 GENESEE STREET
ROCHESTER NY 14611

Officer/Director/Trustee Four

TERESA SIPPEL-SCHMIDT
DIRECTOR
W316N8540 SUNSET WAY
HARTLAND WI 53029

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID FRALEY III
Signature Title DIRECTOR
Signature Date 12/14/2020

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