FORM 1023-EZ for WALWORTH COUNTY TAVERN LEAGUE FOUNDATION INC

Field Data
EIN 84-2336325
Case Number EO-2019192-000372
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WALWORTH COUNTY TAVERN LEAGUE FOUNDATION INC
Organization’s Mailing Address P O BOX 717
City BURLINGTON
State WI
ZIP 53105
Accounting period End 12
Primary contact name BRIAN WANASEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVE HILLS
DIRCTOR/PRESIDENT
3388 DELL PLACE
LAKE GENEVA WI 53147

Officer/Director/Trustee Two

RENEE PETERSON
DIRCTOR/TREAURER
N1289 MAPLE RIDGE ROAD
LAKE GENEVA WI 53147

Officer/Director/Trustee Three

CHRIS MARSICANO
DIRECTOR/ SECRETARY
2211 INLET SHORE DRIVE
DELEVAN WI 53115

Officer/Director/Trustee Four

BRIAN WANASEK
ASSISTANT SECRETARY
P O BOX 717
BURLINGTON WI 53105

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/27/19
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 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 BRIAN WANASEK
Signature Title ASSISTANT SECRETARY
Signature Date 7/9/19

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