FORM 1023-EZ for CARECONNECT INC

Field Data
EIN 82-4939500
Case Number EO-2018107-000578
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CARECONNECT INC
Organization’s Mailing Address 4319 NORTH 76TH STREET SUITE 10
City MIWAUKEE
State WI
ZIP 53222
Accounting period End 12
Primary contact name ROOSEVELT LEE RICHARDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY LONG
PRESIDENT
10303 WEST TOWER AVE
MILWAUKEE WI 53224

Officer/Director/Trustee Two

STEPHANIE JOHNSON
TREASURE
3734 NORTH 86TH STREET
MILWAUKEE WI 53222

Officer/Director/Trustee Three

RICHARD NONHOF
SECRETARY
1720 SOUTH 29TH STREET APT 319
MILWAUKEE WI 53215

Officer/Director/Trustee Four

ROOSEVELT RICHARDSON
EXECUTIVE DIRECTOR
5361 NORTH 50TH STREET
MILWAUKEE WI 53218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROOSEVELT RICHARDSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 3/27/18

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