FORM 1023-EZ for OSHKOSH AREA BUSINESSES FOCUSED ONHEALTH INC

Field Data
EIN 47-2248849
Case Number EO-2014363-000142
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OSHKOSH AREA BUSINESSES FOCUSED ONHEALTH INC
Organization’s Mailing Address 324 WASHINGTON AVENUE
City OSHKOSH
State WI
ZIP 54901-5042
Accounting period End 12
Primary contact name THOMAS W MONIZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MOLLY BUTZ
PRESIDENT
324 WASHINGTON AVENUE
OSHKOSH WI 54901-5042

Officer/Director/Trustee Two

PATRICIA SALOMEN
TREASURER
215 NORTH WESTFIELD STREET
OSHKOSH WI 54902

Officer/Director/Trustee Three

MEGAN KLUG
VICE PRESIDENT
N9642 COUNTY ROAD N
APPLETON WI 54915

Officer/Director/Trustee Four

PAM BERTH
SECRETARY
820 ASSOCIATION DRIVE
APPLETON WI 54914

Officer/Director/Trustee Five

EMILY DIERINGER
DIRECTOR
PO BOX 2808
OSHKOSH WI 54903

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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