FORM 1023-EZ for TARGETED RESTART INCORPORATED

Field Data
EIN 27-0188336
Case Number EO-2014247-000082
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TARGETED RESTART INCORPORATED
Organization’s Mailing Address 573
City APPLETON
State WI
ZIP 54912
Accounting period End 12
Primary contact name ELAINE EAGLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELAINE EAGLE
CEO/CHAIRMAN
2500 HONEY LOU COURT 104
APPLETON WI 54915

Officer/Director/Trustee Two

THOMAS MITTELSTEADT
CO-CHAIRMAN
1923 IOWA STREET
OSHKOSH WI 54902

Officer/Director/Trustee Three

GENE JURCZYK
TRESURER
185 SOUTH WESTHAVEN 212
OSHKOSH WI 54904

Officer/Director/Trustee Four

DEANA KRABBE
SECRETARY
237 1/2 NORTH JOHN STREET
KIMBERLY WI 54136

Officer/Director/Trustee Five

LARRY BURG
TRUSTEE
1144 SOUTH PARK AVENUE
FOND DU LAC WI 54935

Organization’s website HTTP://WWW.TARGETEDRESTARTINC.WIX.COM/TEMPSITE
Organization’s email TARGETEDRESTARTINC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/2009
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I40 - Rehabilitation Services for Offenders
Organization’s purpose Charitable: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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