FORM 1023-EZ for COUNTRY AND CITY MISSION FOR NORTHEASTERN WISCONSIN AND THE UP

Field Data
EIN 83-4407469
Case Number EO-2019115-000225
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUNTRY AND CITY MISSION FOR NORTHEASTERN WISCONSIN AND THE UP
Organization’s Mailing Address 160 SOUTH STATE HWY M553 LOT 127
City GWINN
State MI
ZIP 49841
Accounting period End 12
Primary contact name JUDY GERMAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUDY GERMAIN
PRESIDENT/DIRECTOR
160 SOUTH STATE HWY M553 LOT 127
GWINN MI 49841

Officer/Director/Trustee Two

KERRI DOONAN
VICE-PRESIDENT/DIRECTOR
629 WEST FRANKLIN STREET
APPLETON WI 54911

Officer/Director/Trustee Three

LEAH RODDA
SECRETARY/DIRECTOR
580 COX AVENUE NO 216
MARQUETTE MI 49855

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 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 JUDY GERMAIN
Signature Title PRESIDENT/DIRECTOR
Signature Date 4/23/19

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