FORM 1023-EZ for MISSION NUTRITION DEFOREST INC

Field Data
EIN 85-2205027
Case Number EO-2020224-000312
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSION NUTRITION DEFOREST INC
Organization’s Mailing Address PO BOX 123
City DEFOREST
State WI
ZIP 53532-0123
Accounting period End 12
Primary contact name LEIGH FELDMANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOANN BREGGEMAN
PRESIDENT
5710 COUNTY HIGHWAY V
DEFOREST WI 53532-1812

Officer/Director/Trustee Two

LEIGH FELDMANN
TREASURER
1330 PINNACLE CIR
SUN PRAIRIE WI 53590-3575

Officer/Director/Trustee Three

DAWN PETERSON
VICE PRESIDENT
7844 HIGHWAY 51
DEFOREST WI 53532-2032

Organization’s website NA
Organization’s email MNDEFOREST@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 LEIGH FELDMANN
Signature Title TREASURER
Signature Date 8/6/2020

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