FORM 1023-EZ for SERRA CLUB OF WISCONSIN SOUTHERN LAKES

Field Data
EIN 39-1742779
Case Number EO-2021043-000170
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SERRA CLUB OF WISCONSIN SOUTHERN LAKES
Organization’s Mailing Address 333 WEST WACKER DRIVE SUITE 500
City CHICAGO
State IL
ZIP 60606-1226
Accounting period End 5
Primary contact name ROBERT CAMPNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT CAMPNEY
TRUSTEE
15918 PATRICK AVE
OMAHA NE 68116

Officer/Director/Trustee Two

DANIEL MILLER
PRESIDENT
931 E AUER AVE
MILWAUKEE WI 53212

Officer/Director/Trustee Three

THERESE MILLER
SECRETARY
6408 WHEATLAND RD
BURLINGTON WI 53105

Officer/Director/Trustee Four

JOAN SIPPEL
TREASURER
125 MEADOWLARK DR APT 7
BURLINGTON WI 53105

Officer/Director/Trustee Five

JAMES WEIS
TRUSTEE
2600 CEDAR DR
BURLINGTON WI 53105

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/16/1990
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X22 - Roman Catholic
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name ROBERT CAMPNEY
Signature Title TRUSTEE
Signature Date 12/10/2020

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