FORM 1023-EZ for SAFE SKIES CLEAN WATER WI INC

Field Data
EIN 85-4206838
Case Number EO-2021054-000109
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAFE SKIES CLEAN WATER WI INC
Organization’s Mailing Address 1148 WILLIAMSON STREET
City MADISON
State WI
ZIP 53703
Accounting period End 12
Primary contact name DARCY HABER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARCY HABER
CO-CHAIR, REGISTERED AGENT
1148 WILLIAMSON STREET
MADISON WI 53703

Officer/Director/Trustee Two

BRAD GEYER
CO-CHAIR
3834 WHITMAN LANE
MADISON WI 53704

Officer/Director/Trustee Three

STEVE KLAFKA
TREASURER
508 ELMSIDE BOULEVARD
MADISON WI 53704

Officer/Director/Trustee Four

TOM BOSWELL
SECRETARY
1942 SACHTJEN STREET
MADISON WI 53704

Officer/Director/Trustee Five

LANCE GREEN
DIRECTOR
186 DIXON STREET
MADISON WI 53704

Organization’s website SafeSkiesCleanWaterWi.org
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S01 - Alliance/Advocacy Organizations
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 No
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 DARCY HABER
Signature Title CO-CHAIR, REGISTERED AGENT
Signature Date 12/23/2020

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