FORM 1023-EZ for BADGER HOSPICE FOUNDATION INC

Field Data
EIN 83-1582298
Case Number EO-2018235-000460
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BADGER HOSPICE FOUNDATION INC
Organization’s Mailing Address 125 N EXECUTIVE DR STE100
City BROOKFIELD
State WI
ZIP 53005
Accounting period End 12
Primary contact name RYAN ZENK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BARBARA HORSTMEYER
DIRECTOR
125 N EXECUTIVE DR STE 100
BROOKFILED WI 53005

Officer/Director/Trustee Two

RYAN ZENK
DIRECTOR
125 N EXECUTIVE DR STE 100
BROOKFIELD WI 53005

Officer/Director/Trustee Three

JOHN COURY
DIRECTOR
125 N EXECUTIVE DR STE 100
BROOKFIELD WI 53005

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/26/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P74 - Hospice
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 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 RYAN ZENK
Signature Title DIRECTOR
Signature Date 8/21/18

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