FORM 1023-EZ for JACOB LEE SCHULTZ SWIMMING MEMORIAL

Field Data
EIN 47-3143948
Case Number EO-2015201-000119
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JACOB LEE SCHULTZ SWIMMING MEMORIAL
Organization’s Mailing Address 20593 CTY HWY ZZ
City CORNELL
State WI
ZIP 54732
Accounting period End 12
Primary contact name KESSEA KAHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KESSEA KAHL
DIRECTOR
20593 CO HWY ZZ
CORNELL WI 54732

Officer/Director/Trustee Two

DEBRA HETCHLER
TRUSTEE
220 TOWNLINE ROAD N
CORNELL WI 54732

Officer/Director/Trustee Three

KARI RADA
TRUSTEE
2427 9 1/4 AVENUE
CHETEK WI 54728

Officer/Director/Trustee Four

RENEE HAMBY
TRUSTEE
STATE HWY 178
CORNELL WI 54732

Organization’s website HTTPS://SITES.GOOGLE.COM/SITE/JLSSWIMMINGMEMORIAL/
Organization’s email JLSSWIMMINGMEMORIAL@HOTMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
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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