FORM 1023-EZ for 12PLUS1 INC

Field Data
EIN 82-1063472
Case Number EO-2017205-000175
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 12PLUS1 INC
Organization’s Mailing Address 301 CHEYENNE DR
City WAUKESHA
State WI
ZIP 53188
Accounting period End 6
Primary contact name JOSEPH W NETTESHEIM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH W NETTESHEIM
EXECUTIVE DIRECTOR
301 CHEYENNE DR
WAUKESHA WI 53188

Officer/Director/Trustee Two

MARIBETH NETTESHEIM
DIRECTOR
301 CHEYENNE DR
WAUKESHA WI 53188

Officer/Director/Trustee Three

MAUREEN ROTRAMEL
DIRECTOR
446 JOHNSON STREET
PORT WASHINGTON WI 53074

Officer/Director/Trustee Four

KIMBERLY VANBEEK
DIRECTOR
1215 SOUTH 45TH STREET
MILWAUKEE WI 53214

Officer/Director/Trustee Five

JASON GONZALEZ
DIRECTOR
2753A NORTH WEIL STREET
MILWAUKEE WI 53212

Organization’s website WWW.12PLUS1.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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 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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