FORM 1023-EZ for ST CROIX VALLEY HOME BUILDERS FOUNDATION

Field Data
EIN 84-1939263
Case Number EO-2019156-000264
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ST CROIX VALLEY HOME BUILDERS FOUNDATION
Organization’s Mailing Address PO BOX 654
City HUDSON
State WI
ZIP 54016
Accounting period End 12
Primary contact name JENNIFER URBAN - CAF 0308-14263R
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRIS WILCOX
PRESIDENT & DIRECTOR
707 COMMERCE DR STE 140
ST PAUL MN 55125

Officer/Director/Trustee Two

MICHAEL DERRICK
TREASURER & DIRECTOR
1505 HWY 65
NEW RICHMOND WI 54017

Officer/Director/Trustee Three

TAMI KUCHERA
SECRETARY & DIRECTOR
1010 N MAIN ST
RIVER FALLS WI 54022

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L20 - Housing Development, Construction, Management
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 Yes
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 CHRIS WILCOX
Signature Title PRESIDENT & DIRECTOR
Signature Date 6/3/19

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