FORM 1023-EZ for TRAUMATIC INCIDENT RESOURCE

Field Data
EIN 45-5443540
Case Number EO-2015048-000143
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRAUMATIC INCIDENT RESOURCE
Organization’s Mailing Address 945 N 12TH STREET
City MILWAUKEE
State WI
ZIP 53233
Accounting period End 12
Primary contact name KRISTEN STROTHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JASON MIMS
CHAIRMAN
8920 WEST DENVER AVENUE
MILWAUKEE WI 53224

Officer/Director/Trustee Two

KRISTEN STROTHER
CLINICAL DIRECTOR
739 ROOSEVELT
TWIN LAKES WI 53181

Officer/Director/Trustee Three

ROBERT STOLLENWERK
TREASURER
12104 W CARDINAL COURT
HALES CORNERS WI 53130

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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
Signature Title
Signature Date

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