FORM 1023-EZ for MOONLIGHT RETREAT INC

Field Data
EIN 84-3151353
Case Number EO-2019269-000205
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOONLIGHT RETREAT INC
Organization’s Mailing Address 3033 N HOLTON ST
City MILWAUKEE
State WI
ZIP 53212
Accounting period End 12
Primary contact name NAOMI SHERSTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONICA MILLER
SECRETARY
402 E GARFIELD AVE
MILWAUKEE WI 53202

Officer/Director/Trustee Two

LAURA PORTERFIELD
PRESIDENT
1901 N PROSPECT AVE APT 704
MILWAUKEE WI 53202

Officer/Director/Trustee Three

JENNIFER MUELLER
TREASURER
2813 N BOOTH ST
MILWAUKEE WI 53212

Officer/Director/Trustee Four

FAYTHE LEVINE
DIRECTOR
2105 N 12TH ST
SHEBOYGAN WI 53081

Officer/Director/Trustee Five

NAOMI SHERSTY
TRUSTEE
3033 N HOLTON ST
MILWAUKEE WI 53212

Organization’s website
Organization’s email MOONLIGHTRETREATWI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/19
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 NAOMI SHERSTY
Signature Title TRUSTEE
Signature Date 9/24/19

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