FORM 1023-EZ for ST ELIZABETH HUBERTERS CLUB OF ST ELIZABETH ANN SETON PARISH

Field Data
EIN 82-3047843
Case Number EO-2017286-000360
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ST ELIZABETH HUBERTERS CLUB OF ST ELIZABETH ANN SETON PARISH
Organization’s Mailing Address 515 N MAIN ST
City HOLMEN
State WI
ZIP 54636
Accounting period End 6
Primary contact name PATRICK BRUEGGEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK BRUEGGEN
PRESIDENT
N6775 FREIER RD
HOLMEN WI 54636

Officer/Director/Trustee Two

KEVIN SCHOLZE
VICE PRESIDENT
602 DEERWOOD ST
HOLMEN WI 54636

Officer/Director/Trustee Three

JUDY MC HUGH
SECRETARY
1900 OLD HWY 93
HOLMEN WI 54636

Officer/Director/Trustee Four

LARRY WARZYNSKI
FINANCE OFFICER
W7728 MEADOW WAY
HOLMEN WI 54636

Organization’s website
Organization’s email YOUTH@SEASHOLMEN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2015
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: Yes
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 Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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