FORM 1023-EZ for PEWAUKEE KIWANIS FOUNDATION PEWAUKEE KIWANIS CLUB

Field Data
EIN 47-4250355
Case Number EO-2015208-000478
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PEWAUKEE KIWANIS FOUNDATION PEWAUKEE KIWANIS CLUB
Organization’s Mailing Address 2124 OAKLAWN AVE
City WAUKESHA
State WV
ZIP 53188-2124
Accounting period End 9
Primary contact name PAUL L BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WYATT REPAVICH
PRESIDENT
N42W27821 INDIAN CT
PEWAUKEE WI 53072

Officer/Director/Trustee Two

LORI SIEHR
VICE PRESIDENT
N29W27529 PENINSULA DR
PEWAUKEE WI 53072

Officer/Director/Trustee Three

WILLIAM NICHOLSON
SECRETARY
N28W26637 MIAMI DR
PEWAUKEE WI 53072

Officer/Director/Trustee Four

PAUL BROWN
TREASURER
2124 OAKLAWN AVE
WAUKESHA WI 53188-2124

Officer/Director/Trustee Five

JOHN VITALE
DIRECTOR
W269N2713 LELAH AVE
PEWAUKEE WI 53072

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T31 - Community Foundations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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