FORM 1023-EZ for ACACIA FOUNDATION OF CENTRAL WISCONSIN INC

Field Data
EIN 46-2045257
Case Number EO-2014238-000200
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACACIA FOUNDATION OF CENTRAL WISCONSIN INC
Organization’s Mailing Address 4510 BRECKENRIDGE COURT
City WISCONSIN RAPIDS
State WI
ZIP 54494-9797
Accounting period End 12
Primary contact name THEODORE LYONS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THEODORE LYONS
PRESIDENT
4510 BRECKENRIDGE COURT
WISCONSIN RAPIDS WI 54494-9797

Officer/Director/Trustee Two

CRAIG CARPENTER
VICE PRESIDENT
320 14TH STREET SOUTH
WISCONSIN RAPIDS WI 54494-5002

Officer/Director/Trustee Three

ROBERT CALVERLEY
SECRETARY
7820 DEER ROAD
WISCONSIN RAPIDS WI 54494-9033

Officer/Director/Trustee Four

LUCY RUNNELLS
TREASURER
3411 32ND STREET SOUTH
WISCONSIN RAPIDS WI 54494-1563

Officer/Director/Trustee Five

THOMAS REICHERT
MEMBER
411 9TH STREET NORTH
WISCONSIN RAPIDS WI 54494-3612

Organization’s website
Organization’s email TLYONS@WCTC.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/5/2013
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief 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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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