FORM 1023-EZ for 5-STONES INC

Field Data
EIN 27-3792602
Case Number EO-2014307-000252
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 5-STONES INC
Organization’s Mailing Address 2601 N MORRISON ST
City APPLETON
State WI
ZIP 54911
Accounting period End 12
Primary contact name CONNIE CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CONNIE CAMPBELL
PRESIDENT
2601 N MORRISON ST
Appleton WI 54911

Officer/Director/Trustee Two

BEN STEWART
DIRECTOR
7775 CHANCELLOR DR
Colorado Springs CO 80920

Officer/Director/Trustee Three

SHEILA MOORE
DIRECTOR
1402 ROGERS CT
NEENAH WI 54956

Organization’s website 5-STONES.ORG
Organization’s email CCAMPBELL@5-STONES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/2010
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I73 - Sexual Abuse, Prevention of
Organization’s purpose Charitable: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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