FORM 1023-EZ for MICHAEL HELLENBRAND MEMORIAL FUND INC

Field Data
EIN 87-1865628
Case Number EO-2021211-000308
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MICHAEL HELLENBRAND MEMORIAL FUND INC
Organization’s Mailing Address 5157 N HILL POINT RD
City CROSS PLAINS
State WI
ZIP 53528-9335
Accounting period End 12
Primary contact name MELISSA K WARNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDA HELLENBRAND
PRESIDENT
5157 N HILL POINT RD
CROSS PLAINS WI 53528

Officer/Director/Trustee Two

DANIEL BASSE
VICE PRESIDENT
951 PRIVATE ROAD
WINNETKA IL 60093

Officer/Director/Trustee Three

DR SHEILA MCGUIRK
SECRETARY
3720 COUNTY RD M
DODGVILLE WI 53533

Officer/Director/Trustee Four

ROBERT HAGENOW
TREASURER
N2938 HAGEN RD
POYNETTE WI 53955

Officer/Director/Trustee Five

BRYAN VOEGELI
DIRECTOR
N7190 HWY 60
MONTICELLO WI 53570

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/28/2021
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O52 - Youth Development - Agricultural
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 LINDA HELLENBRAND
Signature Title PRESIDENT
Signature Date 7/28/2021

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