FORM 1023-EZ for PEDERSEN ELEMENTARY PTO

Field Data
EIN 39-1828845
Case Number EO-2015133-000133
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PEDERSEN ELEMENTARY PTO
Organization’s Mailing Address 1827 BARTLETT AVE
City ALTOONA
State WI
ZIP 54720
Accounting period End 8
Primary contact name JENNIFER HUGHES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KARLA GEYEN
PRESIDENT
807 SANDALWOOD DR
ALTOONA WI 54720

Officer/Director/Trustee Two

KATIE KUENKEL
SECRETARY
7485 ELAYNE DR
EAU CLAIRE WI 54701

Officer/Director/Trustee Three

JENNIFER HUGHES
TREASURER
1575 E PARK CREEK RD
FALL CREEK WI 54742

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/2011
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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