FORM 1023-EZ for FRIENDS OF HAUMERSONS POND

Field Data
EIN 46-3464928
Case Number EO-2018101-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRIENDS OF HAUMERSONS POND
Organization’s Mailing Address N2192 CLEAR VIEW LANE
City FORT ATKINSON
State WI
ZIP 53538
Accounting period End 12
Primary contact name TIM CARNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE MODE
PRESIDENT
N2192 CLEAR VIEW LANE
FORT ATKINSON WI 53538

Officer/Director/Trustee Two

TIM CARNES
TREASURER
N1761 AGNES ROAD
FORT ATKINSON WI 53538

Officer/Director/Trustee Three

SUE HARTWICK
DIRECTOR
704 N MAIN STREET
FORT ATKINSON WI 53538

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/13
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N31 - Community Recreational Centers
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 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 TIM CARNES
Signature Title TREASURER
Signature Date 4/9/18

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