FORM 1023-EZ for MENS SHED MIDWEST

Field Data
EIN 86-3082495
Case Number EO-2021104-000019
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MENS SHED MIDWEST
Organization’s Mailing Address N5178 KNOLL DR
City SULLIVAN
State WI
ZIP 53178
Accounting period End 3
Primary contact name JACK BENJAMIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICHOLAS BREACH
TREASURER
1490 TURNBERRY CIRCLE
OCONOMOWOC WI 53066

Officer/Director/Trustee Two

STEVE ROBLEE
SECRETARY
N6546 COUNTY ROAD F
OCONOMOWOC WI 53066

Officer/Director/Trustee Three

BOB FORS
GENERAL BOARD MEMBER
2534 LANCASTER DR
WAUKESHA WI 53188

Officer/Director/Trustee Four

JOHN BENJAMIN
EXECUTIVE DIRECTOR AND PRESIDENT
N5178 KNOLL DR
SULLIVAN WI 53178

Organization’s website WWW.MENSSHEDMIDWEST.ORG
Organization’s email JACK.BENJAMIN@CHILDRENSCUP.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S82 - Men's Service Clubs
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 JOHN BENJAMIN
Signature Title EXECUTIVE DIRECTOR AND PRESIDENT
Signature Date 4/7/2021

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