FORM 1023-EZ for LO MARIE FOUNDATION INC

Field Data
EIN 47-5426555
Case Number EO-2019210-000264
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LO MARIE FOUNDATION INC
Organization’s Mailing Address 610 CLEAR SPRING CT
City MONONA
State WI
ZIP 53716-2032
Accounting period End 12
Primary contact name LAUREN HOMBURG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN HOMBURG
DIRECTOR/PRESIDENT
610 CLEAR SPRING CT
MONONA WI 53716-2032

Officer/Director/Trustee Two

ANDREW HOMBURG
SECRETARY/TREASURER
6106 MILWAUKEE ST
MADISON WI 53718-6412

Officer/Director/Trustee Three

MARK GOFF
VICE PRESIDENT
5590 MONONA DR
MONONA WI 53716-3131

Organization’s website WWW.LOMARIEMUSIC.COM/THE-LO-MARIE-FOUNDATION
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/15
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
Organization’s purpose Charitable: Yes
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LAUREN HOMBURG
Signature Title DIRECTOR/PRESIDENT
Signature Date 7/25/19
EIN 47-5426555
Case Number EO-2017121-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LO MARIE FOUNDATION INC
Organization’s Mailing Address 5590 MONONA DR
City MONONA
State WI
ZIP 53716-3131
Accounting period End 12
Primary contact name LAUREN HOMBURG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN HOMBURG
DIRECTOR, PRESIDENT
2001 REINER RD
MADISON WI 53718-6342

Officer/Director/Trustee Two

ANDREW HOMBURG
DIRECTOR, SECRETARY, TREASURER
6106 MILWAUKEE ST
MADISON WI 53718-6412

Officer/Director/Trustee Three

MARK GOFF
DIRECTOR, VICE-PRESIDENT
5590 MONONA DR
MONONA WI 53716-3131

Organization’s website WWW.LOMARIEMUSIC.COM/LO-MARIE-FOUNDATION
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/21/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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