FORM 1023-EZ for DOWN SYNDROME ASSOCIATION OF WISCONSIN -FAMILY SERVICES INC

Field Data
EIN 47-2468749
Case Number EO-2014349-000432
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOWN SYNDROME ASSOCIATION OF WISCONSIN -FAMILY SERVICES INC
Organization’s Mailing Address 3211 S LAKE DRIVE SUITE 113
City ST FRANCIS
State WI
ZIP 53235
Accounting period End 12
Primary contact name RON MALLOY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELLEN TRYTEK
BOARD PRESIDENT
14205 APPLEWOOD COURT
ELM GROVE WI 53122

Officer/Director/Trustee Two

MARK ANDRES
BOARD VICE PRESIDENT
11626 W GARFIELD AVENUE
WAUWATOSA WI 53226

Officer/Director/Trustee Three

JILL BOYLE
BOARD TREASURER
11414 W PARK PLACE SUITE 200
MILWAUKEE WI 53224

Officer/Director/Trustee Four

JOE MALLOY
BOARD SECRETARY
523 MCCALL STREET
WAUKESHA WI 53186

Officer/Director/Trustee Five

LEE BERNFELD
VOTING MEMBER AT LARGE
3185 S PINEWOOD CREEK COURT
NEW BERLIN WI 53151

Organization’s website WWW.DSAWFAMILYSERVICES.ORG
Organization’s email ELLENMTRYTEK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - 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 Yes
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 Yes
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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