FORM 1023-EZ for SUSTAINABILITY INSTITUTE INC

Field Data
EIN 47-3133436
Case Number EO-2015054-000329
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUSTAINABILITY INSTITUTE INC
Organization’s Mailing Address 400 7TH STREET NORTH
City LA CROSSE
State WI
ZIP 54602
Accounting period End 12
Primary contact name PATTI BALACEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LEE RASCH
PRESIDENT AND BOARD MEMBER
4100 EASTER ROAD
LA CROSSE WI 54601

Officer/Director/Trustee Two

MICHAEL PATTERSON
BOARD MEMBER
N1655 HAGEN ROAD
LA CROSSE WI 54601

Officer/Director/Trustee Three

PATTI BALACEK
EXECUTIVE DIRECTOR
400 7TH STREET NORTH
LA CROSSE WI 54602

Officer/Director/Trustee Four

KATIE BITTNER
SECRETARY AND BOARD MEMBER
1027 CHARLES STREET
LA CROSSE WI 54603

Officer/Director/Trustee Five

SHANNON HAVLIK
BOARD MEMBER
6500 STATE ROAD 16
LA CROSSE WI 54601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S31 - Urban, Community Economic Development
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 No
One Third Support Gifts Yes
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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