FORM 1023-EZ for HOPE INSTILLED INC

Field Data
EIN 81-3559579
Case Number EO-2016266-000183
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOPE INSTILLED INC
Organization’s Mailing Address 4282 NORTH WILSON DRIVE SUITE 100
City SHOREWOOD
State WI
ZIP 53211-1447
Accounting period End 12
Primary contact name JORY PRADJINSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JORY PRADJINSKI
CHIEF EXECUTIVE OFFICER, PRESIDENT
4282 NORTH WILSON DRIVE
SHOREWOOD WI 53211-1447

Officer/Director/Trustee Two

THOMAS JACOBSON
TREASURER, DIRECTOR
9355 WEST GREENVIEW COURT
MILWAUKEE WI 53224-6152

Officer/Director/Trustee Three

KURT ROSKOPF
CHAIRPERSON, DIRECTOR
N79W22125 BRAMBLE DRIVE
SUSSEX WI 53089-2103

Officer/Director/Trustee Four

SARAH PRADJINSKI
TRUSTEE
18785 DAVIDSON ROAD
BROOKFIELD WI 53045-6614

Officer/Director/Trustee Five

SHANE BRION
TRUSTEE
1127 NORTH 12TH STREET
SHEBOYGAN WI 53081-8579

Organization’s website WWW.HOPEINSTILLED.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/2016
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 Yes
Donation of funds Yes
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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