FORM 1023-EZ for COMMUNITY SOURCED INC
| Field | Data |
|---|---|
| EIN | 84-1957070 |
| Case Number | EO-2019207-000312 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY SOURCED INC |
| Organization’s Mailing Address | PO BOX 77 |
| City | DELAVAN |
| State | WI |
| ZIP | 53115 |
| Accounting period End | 12 |
| Primary contact name | TIMOTHY M BROVOLD |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SCOTT CAMPBELL
PRESIDENT, EXECUTIVE DIRECTOR
PO BOX 77
DELAVAN WI 53115
Officer/Director/Trustee Two
KATIE DAUDELIN
TREASURER
PO BOX 77
DELAVAN WI 53115
Officer/Director/Trustee Three
KATIE CAMPBELL
DIRECTOR
PO BOX 77
DELAVAN WI 53115
Officer/Director/Trustee Four
LUKAS JANAKY
DIRECTOR
PO BOX 77
DELAVAN WI 53115
Officer/Director/Trustee Five
NIKKI INTINE
DIRECTOR
PO BOX 77
DELAVAN WI 53115
| Organization’s website | COMMUNITYSOURCED.ORG |
|---|---|
| Organization’s email | COMMUNITYSOURCED@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/30/19 |
| Organization Incorporation State | WI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | K30 - Food Service, Free Food Distribution Programs |
| 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 | Yes |
| 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 | SCOTT CAMPBELL |
| Signature Title | PRESIDENT, EXECUTIVE DIRECTOR |
| Signature Date | 7/24/19 |
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