FORM 1023-EZ for LIGHTHOUSE ORG

Field Data
EIN 26-1972672
Case Number EO-2016029-000235
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHTHOUSE ORG
Organization’s Mailing Address PO BOX 42
City LADYSMITH
State WI
ZIP 54848
Accounting period End 12
Primary contact name PEGGY MCMAHON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS FUHRMANN
CHAIR
N3102 CRANBERRY LAKE RD
WEYERHAEUSER WI 54895

Officer/Director/Trustee Two

PEGGY MCMAHON
TREASURER
N5340 RIVERVIEW ROAD
LADYSMITH WI 54848

Officer/Director/Trustee Three

NANCY DAILEY
SECRETARY
W8193 BIRCH ROAD
LADYSMITH WI 54848

Officer/Director/Trustee Four

LEROY OPSAL
ASSISTANT CHAIR
700 RIVER AVE E
LADYSMITH WI 54848

Officer/Director/Trustee Five

MARY HOLMES
BOARD MEMBER
N3820 HWY 40
BRUCE WI 54819

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/2008
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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