FORM 1023-EZ for CORTINA GLOBAL MEDICAL FUND INC

Field Data
EIN 81-1220094
Case Number EO-2016040-000133
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CORTINA GLOBAL MEDICAL FUND INC
Organization’s Mailing Address 4305 NORTH FARWELL AVENUE
City SHOREWOOD
State WI
ZIP 53211
Accounting period End 12
Primary contact name LARS OLSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LARS OLSON
PRESIDENT
4305 NORTH FARWELL AVENUE
SHOREWOOD WI 53211

Officer/Director/Trustee Two

MARY LYSAUGHT
VICE PRESIDENT
N34W7420 LINCOLN BOULEVARD
CEDARBURG WI 53012

Officer/Director/Trustee Three

MARA SCHWARTZ
TREASURER
2209 WEST KENDALL AVENUE
GLENDALE WI 53209

Officer/Director/Trustee Four

CHRISTOPHER HALLBERG
SECRETARY
2315 EAST SPRING STREET APARTMENT 1
SEATTLE WA 98122

Officer/Director/Trustee Five

MATTHEW GLUCKSBERG
BOARD MEMBER AT LARGE
3150 NORTH LAKE SHORE DRIVE
CHICAGO IL 60657

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/6/2016
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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