FORM 1023-EZ for STAGE III THEATRE FOR YOUTH INC

Field Data
EIN 81-5016694
Case Number EO-2017079-000404
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STAGE III THEATRE FOR YOUTH INC
Organization’s Mailing Address 101 11TH STREET
City BARABOO
State WI
ZIP 53913
Accounting period End 12
Primary contact name CLIFFORD D BOBHOLZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN ELDRED-KUJAWA
PRESIDENT
101 11TH STREET
BARABOO WI 53913

Officer/Director/Trustee Two

ANTHONY KUJAWA
TREASURER DIRECTOR
101 11TH STREET
BARABOO WI 53913

Officer/Director/Trustee Three

TIMOTHY LOWE
DIRECTOR
S6274 BLUFF ROAD
MERRIMAC WI 53561

Officer/Director/Trustee Four

GRETCHEN ROLTGEN
DIRECTOR
230 4TH STREET
BARABOO WI 53913

Officer/Director/Trustee Five

KARI NELSON
DIRECTOR
468 GULCH ROAD
WISCONSIN DELLS WI 53965

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
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 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 Yes
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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