FORM 1023-EZ for STORK COMPANY OF WISCONSIN INC

Field Data
EIN 47-1957932
Case Number EO-2014300-000380
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STORK COMPANY OF WISCONSIN INC
Organization’s Mailing Address 8138 SOUTH COUNTRY CLUB CIRCLE
City FRANKLIN
State WI
ZIP 53132
Accounting period End 12
Primary contact name TRACY BUSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TRACY BUSS
PRESIDENT AND TREASURER
8138 SOUTH COUNTRY CLUB CIRCLE
FRANKLIN WI 53132

Officer/Director/Trustee Two

MEENA NUTBEAM
VICE-PRESIDENT
8138 SOUTH COUNTRY CLUB CIRCLE
FRANKLIN WI 53132

Officer/Director/Trustee Three

ZACHARY BRUBAKER
SECRETARY
11725 WEST SCHERREI DRIVE
FRANKLIN WI 53132

Organization’s website STORKANDCOMPANY.ORG
Organization’s email MEENANUTBEAM1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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
Signature Title
Signature Date

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