FORM 1023-EZ for STATELINE WORKS OF MERCY INC
| Field | Data |
|---|---|
| EIN | 87-2081802 |
| Case Number | EO-2021246-000075 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | STATELINE WORKS OF MERCY INC |
| Organization’s Mailing Address | PO BOX 1341 |
| City | BELOIT |
| State | WI |
| ZIP | 53512 |
| Accounting period End | 12 |
| Primary contact name | KELLI PETERSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
THOMAS MCGINNISS
CHAIRPERSON
12363 DUNHAM DRIVE
ROSCOE IL 61073
Officer/Director/Trustee Two
BILL JENKINS
DIRECTOR
715 BALDWIN WOODS
BELOIT WI 53511
Officer/Director/Trustee Three
KAREN KAVANAUGH
DIRECTOR
744 MILWAUKEE RD
BELOIT WI 53511
Officer/Director/Trustee Four
DEB BURNS
DIRECTOR
856 E HART RD
BELOIT WI 53511
Officer/Director/Trustee Five
DEBRA MCGINNISS
DIRECTOR
12363 DUNHAM DR
ROSCOE IL 61073
| Organization’s website | |
|---|---|
| Organization’s email | STATELINEWORKSOFMERCY@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/2/2021 |
| Organization Incorporation State | WI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P85 - Homeless Persons Centers, Services |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | Yes |
| Gaming Activity | Yes |
| 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 | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | No |
| Signature Name | DEBRA MCGINNISS |
| Signature Title | DIRECTOR |
| Signature Date | 9/1/2021 |
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