FORM 1023-EZ for SLEEP WELL NEBRASKA

Field Data
EIN 81-2575243
Case Number EO-2016243-000560
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SLEEP WELL NEBRASKA
Organization’s Mailing Address 5401 QUAIL RIDGE CT
City LINCOLN
State NE
ZIP 68516
Accounting period End 1
Primary contact name KELLY CUMMINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRETT WIESKAMP
PRESIDENT
4308 BINGHAM CIRCLE
LINCOLN NE 68516

Officer/Director/Trustee Two

TERESA DIXON
VICE PRESIDENT
310 STATE HIGHWAY 34 B SPUR
FIRTH NE 68358

Officer/Director/Trustee Three

BETH BUSBOOM
TREASURER
5938 EAST BIRCH ROAD
ADAMS NE 68301

Officer/Director/Trustee Four

TRICIA BROWN
SECRETARY
7651 BALDWIN AVENUE
LINCOLN NE 68507

Officer/Director/Trustee Five

KELLY CUMMINS
EXECUTIVE DIRECTOR
5401 QUAIL RIDGE CT
LINCOLN NE 68516

Organization’s website SLEEPWELLNEBRASKA.ORG
Organization’s email SLEEPWELLNEBRASKA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2016
Organization Incorporation State NE
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: 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 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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