FORM 1023-EZ for THE NICKY FOR ROB INC

Field Data
EIN 83-3139917
Case Number EO-2019035-000967
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE NICKY FOR ROB INC
Organization’s Mailing Address 1300 SEDONA CIRCLE
City ONEIDA
State WI
ZIP 54155
Accounting period End 12
Primary contact name KEITH BRUNETTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALICIA PURPUR
PRESIDENT
1300 SEDONA CIRCLE
ONEIDA WI 54155

Officer/Director/Trustee Two

DAVID SELISSEN
DIRECTOR
2263 EARLY STREET
GREEN BAY WI 54304

Officer/Director/Trustee Three

MARK MAZZOLENI
DIRECTOR
1832 CHARLES STREET
DE PERE WI 54115

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/19
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 ALICIA PURPUR
Signature Title PRESIDENT
Signature Date 1/15/19

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