FORM 1023-EZ for SMILING FOR SAMUEL INC

Field Data
EIN 84-3837860
Case Number EO-2020029-000435
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SMILING FOR SAMUEL INC
Organization’s Mailing Address N6385 STATE HIGHWAY 73
City NEILLSVILLE
State WI
ZIP 54456
Accounting period End 12
Primary contact name SIERRA STRANGFELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SIERRA STRANGFELD
DIRECTOR
N6385 STATE HIGHWAY 73
NEILLSVILLE WI 54456

Officer/Director/Trustee Two

WHITNEY STATZ
DIRECTOR
W6216 S MOUND ROAD
NEILLSVILLE WI 54460

Officer/Director/Trustee Three

ALAN BUCHHOLZ
DIRECTOR
511 W 7TH STREET
NEILLSVILLE WI 54456

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/17/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 No
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 SIERRA STRANGFELD
Signature Title DIRECTOR
Signature Date 1/27/2020

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