FORM 1023-EZ for COMMUNITY COUNTRY DINNER SHOW INC

Field Data
EIN 84-3106544
Case Number EO-2019266-000365
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY COUNTRY DINNER SHOW INC
Organization’s Mailing Address E5290 JOSSIE RD
City MANAWA
State WI
ZIP 54949
Accounting period End 12
Primary contact name TAMMY PETHKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMMY PETHKE
DIRECTOR
E5290 JOSSIE RD
MANAWA WI 54949

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/19
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 TAMMY PETHKE
Signature Title DIRECTOR
Signature Date 9/19/19

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