FORM 1023-EZ for NORWALK SPORTSMANS CLUB INC

Field Data
EIN 82-3513129
Case Number EO-2017333-000457
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORWALK SPORTSMANS CLUB INC
Organization’s Mailing Address 204 S WATER ST
City NORWALK
State WI
ZIP 54648-7105
Accounting period End 12
Primary contact name ATTORNEY GENE CISEWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWN ROY
PRESIDENT, REGISTERED AGENT, DIRECT
204 S WATER ST
NORWALK WI 54648-7105

Officer/Director/Trustee Two

GREG DECKER
DIRECTOR
303 N WEST ST
NORWALK WV 54648

Officer/Director/Trustee Three

LUCAS BENDER
DIRECTOR, TREASURER
309 ACADEMY ST
ELROY WI 53929-1203

Officer/Director/Trustee Four

LISA ROY
DIRECTOR
204 S WATER ST
NORWALK WI 54648-7105

Organization’s website
Organization’s email NORWALKSPORTSMANSCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C30 - Natural Resources Conservation and Protection
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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