FORM 1023-EZ for LIFT LODI

Field Data
EIN 87-1996439
Case Number EO-2021270-000418
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFT LODI
Organization’s Mailing Address N2093 REAL SHORT RD
City LODI
State WI
ZIP 53555
Accounting period End 6
Primary contact name SARAH KEYESKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARAH KEYESKI
PRESIDENT
N2093 REAL SHORT RD
LODI WI 53555-9656

Officer/Director/Trustee Two

KIM COOKE
SECRETARY
N2085 REAL SHORT RD
LODI WI 53555-9656

Officer/Director/Trustee Three

JENNIFER SEIDLER
TREASURER
1900 SOUTH AVE
LA CROSSE WI 54601

Organization’s website WWW.LIFTLODI.COM
Organization’s email SARAHKEYESKI@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2021
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 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 SARAH KEYESKI
Signature Title PRESIDENT
Signature Date 9/24/2021

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