FORM 1023-EZ for PLATTEVILLE AREA SENIOR SERVICES

Field Data
EIN 81-5188290
Case Number EO-2017275-000295
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PLATTEVILLE AREA SENIOR SERVICES
Organization’s Mailing Address 540 W MADISON
City PLATTEVILLE
State WI
ZIP 53818-1621
Accounting period End 12
Primary contact name WILLIAM CRAMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM CRAMER
PRESIDENT
125 N 3RD ST APT 2
PLATTEVILLE WI 53818-1621

Officer/Director/Trustee Two

GARY POTHOUR
VICE PRESIDENT
6074 SUNRISE DR
PLATTEVILLE WI 53818-1621

Officer/Director/Trustee Three

JOHN KLOSTERMAN
SECRETARY/TREASURER
470 N WATER ST
PLATTEVILLE WI 53818-1621

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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