FORM 1023-EZ for THERESA FIREMENS PARK INCORPORATED

Field Data
EIN 30-0426966
Case Number EO-2016062-000172
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THERESA FIREMENS PARK INCORPORATED
Organization’s Mailing Address 302 DEPOT ROAD
City THERESA
State WI
ZIP 53091
Accounting period End 4
Primary contact name MATTHEW D BREHMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JASON STEIN
PRESIDENT DIRECTOR
209 WILLOW LANE
THERESA WI 53091

Officer/Director/Trustee Two

CASEY SCHWARTZ
VICE PRESIDENT DIRECTOR
N8089 PEREGRINE LANE
HORICON WI 53032

Officer/Director/Trustee Three

RUSSELL GRANTMAN
SECRETARY, TREASURER DIRECTOR
W1723 STATE ROAD 28
THERESA WI 53091

Officer/Director/Trustee Four

KARA BERGER
DIRECTOR
106 MARTIN DRIVE
THERESA WI 53091

Officer/Director/Trustee Five

DAN STEGER
DIRECTOR
N8234 DOYLE ROAD
THERESA WI 53091

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/28/1956
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N32 - Parks and Playgrounds
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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