FORM 1023-EZ for OUR LADY OF KIBEHO BASILICA FOUNDATION INC

Field Data
EIN 82-3282092
Case Number EO-2020268-000421
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OUR LADY OF KIBEHO BASILICA FOUNDATION INC
Organization’s Mailing Address 1466 FINCH LANE
City GREEN BAY
State WI
ZIP 54313
Accounting period End 12
Primary contact name AMY POLASKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IMMACULEE ILIBAGIZA
BOARD MEMBER
139 E 36TH ST 3
NEW YORK NY 10016

Officer/Director/Trustee Two

EUSTACE MITA
BOARD MEMBER
2501 SEAPORT DR
CHESTER PA 19013

Officer/Director/Trustee Three

AMY POLASKY
BOARD MEMBER
1466 FINCH LANE
GREEN BAY WI 54313

Organization’s website BUILDKIBEHO.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X12 - Fund Raising and/or Fund Distribution
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name AMY POLASKY
Signature Title BOARD MEMBER
Signature Date 9/22/2020

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