FORM 1023-EZ for NORTH CENTRAL WISCONSIN DONATE LIFELLC

Field Data
EIN 82-2436131
Case Number EO-2018227-000210
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH CENTRAL WISCONSIN DONATE LIFELLC
Organization’s Mailing Address 109 ASPEN GROVE LANE
City WAUSAU
State WI
ZIP 54403
Accounting period End 12
Primary contact name JOSHUA K WIESMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNI VANDERKOY
PRESIDENT/DIRECTOR
5509 STEWART AVENUE
WAUSAU WI 54476

Officer/Director/Trustee Two

SHELBY GERBIG-FEHLHABER
TREASURER/DIRECTOR
PO BOX 816
EAGLE RIVER WI 54521-816

Officer/Director/Trustee Three

JOSHUA WIESMAN
CHAIRPERSON/DIRECTOR
109 ASPEN GROVE LANE
WAUSAU WI 54403

Officer/Director/Trustee Four

HEIDI WIESMAN
SECRETARY/DIRECTOR
109 ASPEN GROVE LANE
WAUSAU WI 54403

Officer/Director/Trustee Five

KATIE WOODWARD
VICE PRESIDENT/DIRECTOR
3308 TAPPE DRIVE
WESTON WI 54476

Organization’s website WWW.NORTHCENTRALWIDONATELIFE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/17
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HEIDI WIESMAN
Signature Title SECRETARY/DIRECTOR
Signature Date 8/13/18

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