FORM 1023-EZ for MADAME TESSIE FOUNDATION

Field Data
EIN 85-1007153
Case Number EO-2020143-000210
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MADAME TESSIE FOUNDATION
Organization’s Mailing Address 1387 CELTIC DRIVE
City PATASKALA
State OH
ZIP 43062-8018
Accounting period End 5
Primary contact name CATHERINE A HURLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CATHERINE HURLEY
DIRECTOR
1387 CELTIC DRIVE
PATASKALA OH 43062-8018

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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 CATHERINE HURLEY
Signature Title DIRECTOR
Signature Date 5/20/2020

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