FORM 1023-EZ for CARE FOR DODGE COUNTY INC

Field Data
EIN 81-1976300
Case Number EO-2016140-000314
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARE FOR DODGE COUNTY INC
Organization’s Mailing Address PO BOX 84
City BEAVER DAM
State WI
ZIP 53916-0084
Accounting period End 12
Primary contact name WENDY BORNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WENDY BORNER
PRESIDENT
141 WISCONSIN ST
BEAVER DAM WI 53916

Officer/Director/Trustee Two

JESSICA GESCHKE
VICE PRESIDENT
186 SOUTH WIND TRAIL
HORICON WI 53032

Officer/Director/Trustee Three

AMY SCHROEDER
TREASURER
2302 WHITING ROAD
COTTAGE GROVE WI 53527

Officer/Director/Trustee Four

ANDREA PETERSEN
SECRETARY
103 CAROLINE COURT
BEAVER DAM WI 53916

Organization’s website
Organization’s email CAREFORDODGECOUNTY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2016
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 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
Signature Title
Signature Date

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