FORM 1023-EZ for WISCONSIN ASSOCIATION OF WORKERS COMPENSATION ATTORNEYS INC

Field Data
EIN 39-2024001
Case Number EO-2014297-000647
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WISCONSIN ASSOCIATION OF WORKERS COMPENSATION ATTORNEYS INC
Organization’s Mailing Address 2 E MIFFLIN STREET SUITE 300
City MADISON
State WI
ZIP 53703
Accounting period End 12
Primary contact name BRIAN L ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLIE DOMER
PRESIDENT
3970 N OAKLAND AVE
MILWAUKEE WI 53211

Officer/Director/Trustee Two

CHELSIE SPRINGSTEAD
TREASURER
411 E WISCONSIN AVE SUITE 1800
MILWAUKEE WI 53202

Officer/Director/Trustee Three

PETER SILVER
PRESIDENT ELECT
PO BOX 54
WALES WI 54284

Officer/Director/Trustee Four

KRYSTA KENNEDY
SECRETARY
222 E ERIE STREET SUITE 210
MILWAUKEE WI 53201

Officer/Director/Trustee Five

MARK PARMAN
PAST PRESIDENT
613 FOREST STREET
WAUSAU WI 54403

Organization’s website WWW.WAWCA.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/22/2001
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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