| Field | Data |
|---|---|
| EIN | 47-4791407 |
| Case Number | EO-2016088-000596 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | SAFE HARBOR LYME INC |
| Organization’s Mailing Address | 4801 E OAKVIEW DR |
| City | MILTON |
| State | WI |
| ZIP | 53563 |
| Accounting period End | 12 |
| Primary contact name | JERI DOBSON-CLEMENS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
JERI DOBSON-CLEMENS
BOARD CHAIR
4801 E OAKVIEW DR
MILTON WI 53563
KAREN KELLEY SHERRILL
BOARD VICE CHAIR
224 MASTERS DRIVE S
PEACHTREE CITY GA 30269
JONI HUGHES
BOARD SECRETARY
5510 MAIN STREET
RUNNING WATER SD 57062
SUSAN HENNING
BOARD TREASURER
3084 N WRIGHT ROAD
JANESVILLE WI 53546
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/11/2016 |
| Organization Incorporation State | WI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G80 - Specifically Named Diseases |
| 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 | |
| Signature Title | |
| Signature Date |
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