FORM 1023-EZ for ADAMS COUNTY LAKE ALLIANCE INC

Field Data
EIN 45-4259235
Case Number EO-2017250-000389
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADAMS COUNTY LAKE ALLIANCE INC
Organization’s Mailing Address PO BOX 83
City OXFORD
State WI
ZIP 53952
Accounting period End 12
Primary contact name ERIC EDWARDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

R ERIC EDWARDS
PRESIDENT
3317 EAST PARKER LAKE RD
OXFORD WI 53952

Officer/Director/Trustee Two

ROBERT BERRY
VICE PRESIDENT
404 HILLWOOD LANE
FRIENDSHIP WI 53934

Officer/Director/Trustee Three

WILLIAM PEGLER
SECRETARY- TREASURER
316 FISH COURT
OXFORD WI 53952

Organization’s website ACLAKES.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/2/2007
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C32 - Water Resource, Wetlands Conservation and Management
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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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