FORM 1023-EZ for IOWA COUNTY CANCER COALITION INC

Field Data
EIN 81-4867653
Case Number EO-2017011-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name IOWA COUNTY CANCER COALITION INC
Organization’s Mailing Address PO BOX 36
City COBB
State WI
ZIP 53526
Accounting period End 12
Primary contact name SHERI SPRINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERI SPRINGER
DIRECTOR
1012 AUGUSTA STREET
LINDEN WI 53553

Officer/Director/Trustee Two

CONNIE GARD
DIRECTOR
502 MARILYN DRIVE
COBB WI 53526

Officer/Director/Trustee Three

STEVE CHRISTIANSON
DIRECTOR
165 N IOWA STREET
DODGEVILLE WI 53533

Officer/Director/Trustee Four

GLENDA FAULL
DIRECTOR
271 COUNTY ROAD B
MONTFORT WI 53569

Officer/Director/Trustee Five

JACKIE HODGSON
DIRECTOR
4188 PIKES PEAK ROAD
RIDGEWAY WI 53582

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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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