FORM 1023-EZ for HEALING IDENTITY FOUNDATION INCORPORATED

Field Data
EIN 84-3350000
Case Number EO-2020002-000320
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALING IDENTITY FOUNDATION INCORPORATED
Organization’s Mailing Address W244N4850 SWAN RD
City PEWAUKEE
State WI
ZIP 53072
Accounting period End 1
Primary contact name LISA WENGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARIN WENGER
PRESIDENT
W244 N4850 SWAN RD
PEWAUKEE WI 53072

Officer/Director/Trustee Two

CHRISTINE KEARNEY
TREASURER
W230N7454 E STONERIDGE CT
SUSSEX WI 53089-2082

Officer/Director/Trustee Three

DEA MAR
SECRETARY
1232 REDWING DR
OCONOMOWOC WI 53066

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2019
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
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 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 DARIN WENGER
Signature Title PRESIDENT
Signature Date 12/30/2019

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