FORM 1023-EZ for POLO CLUB OF UW-MADISON INC

Field Data
EIN 47-4764837
Case Number EO-2015236-000062
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POLO CLUB OF UW-MADISON INC
Organization’s Mailing Address 3402 SUGAR MAPLE LN
City VERONA
State WI
ZIP 53593
Accounting period End 12
Primary contact name SAMANTHA DZIERZAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SAMANTHA DZIERZAK
PRESIDENT
402 N EAU CLAIRE AVE APT 209
MADISON WI 53705

Officer/Director/Trustee Two

AUDREY WILDE
TREASURER
408 N HENRY ST APT A1
MADISON WI 53703

Officer/Director/Trustee Three

LAUREN ALDERMAN
SECRETARY
7457 EAST PASS
MADISON WI 53719

Officer/Director/Trustee Four

ALYSSA DANIELS
VICE PRESIDENT
333 W MIFFLIN ST APT 1061
MADISON WI 53703

Officer/Director/Trustee Five

LAUREN SCHAFER
DIRECTOR
2802 REGENT ST
MADISON WI 53703

Organization’s website WWW.POLOCLUBUW.WEEBLY.COM
Organization’s email POLOCLUBUW@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2015
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N69 - Equestrian, Riding
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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
Signature Title
Signature Date

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