FORM 1023-EZ for WATERFORD LIONS FOUNDATION INC

Field Data
EIN 81-5340661
Case Number EO-2019086-000648
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WATERFORD LIONS FOUNDATION INC
Organization’s Mailing Address 23401 HANSON ROAD
City UNION GROVE
State WI
ZIP 53182
Accounting period End 12
Primary contact name BRIAN WANASEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT GUNDERSON
PRESIDENT/DIRECTOR
23401 HANSON ROAD
UNION GROVE WI 53182

Officer/Director/Trustee Two

GARY TILLEROS
SECRETARY/ DIRECTOR
293 OAK HILL CIRCLE
BURLINGTON WI 53105

Officer/Director/Trustee Three

TERRANCE CAIN
TREASURER/DIRECTOR
33438 WASHINGTON AVE
BURLINGTON WI 53105

Officer/Director/Trustee Four

KATHY ROBERS
DIRECTOR
330 OAK HILL CIRCLE
BURLINGTON WI 53105

Officer/Director/Trustee Five

BRIAN WANASEK
ASSISTANT SECRETARY
31111 WASHINGTON AVE
BURLINGTON WI 53105

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T99 - Philanthropy, Voluntarism, and Grantmaking Foundations N.E.C.
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 Yes
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 BRIAN WANASEK
Signature Title ASSISTANT SECRETARY
Signature Date 3/25/19

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