FORM 1023-EZ for NAMI JEFFERSON COUNTY WISCONSIN

Field Data
EIN 47-5171698
Case Number EO-2018010-000067
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NAMI JEFFERSON COUNTY WISCONSIN
Organization’s Mailing Address 217 S WATER ST E APT 2
City FORT ATKINSON
State WI
ZIP 53538
Accounting period End 12
Primary contact name DEBORAH THOMPSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH THOMPSON
PRESIDENT
217 S WATER ST E APT 2
FORT ATKINSON WI 53538

Officer/Director/Trustee Two

NEAL ZINDA
VICE PRESIDENT
217 S WATER ST E APT 2
FORT ATKINSON WI 53538

Organization’s website
Organization’s email NAMI.JEFFERSONWI@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/16
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 DEBORAH THOMPSON
Signature Title PRESIDENT
Signature Date 1/7/18

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