FORM 1023-EZ for MADISON JAZZ INC

Field Data
EIN 47-1135353
Case Number EO-2014223-000309
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MADISON JAZZ INC
Organization’s Mailing Address 4123 S SUNSET CT
City MADISON
State WI
ZIP 53705
Accounting period End 12
Primary contact name ROBERT KERWIN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT KERWIN
PRESIDENT
4123 S SUNSET CT
MADISON WI 53705

Officer/Director/Trustee Two

BRUCE SEVERSON
TREASURER
2635 KENDALL AVE
MADISON WI 53705

Officer/Director/Trustee Three

WILLIAM GOODRICH
AT LARGE
3310 NOTTINGHAM WAY
MADISON WI 53713

Officer/Director/Trustee Four

KEVIN ADLER
SECRETARY
1112 COLBY ST
MADISON WI 53715

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
Organization’s purpose Charitable: Yes
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 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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