FORM 1023-EZ for BENEVOLENCE GUARDIANSHIP SERVICES INC

Field Data
EIN 82-2817191
Case Number EO-2017303-000091
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BENEVOLENCE GUARDIANSHIP SERVICES INC
Organization’s Mailing Address 2906 96TH STREET
City STURTEVANT
State WI
ZIP 53177
Accounting period End 12
Primary contact name ANDREA HUMPHREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREA HUMPHREY
PRESIDENT/CEO
2906 96TH STREET
STURTEVANT WI 53177

Officer/Director/Trustee Two

KIMBERLEY DEVROU
VICE PRESIDENT/SECRETARY
1408 10TH AVE APT 14
UNION GROVE WI 53182

Officer/Director/Trustee Three

MARY WRIGHT
TREASURER
9242 ANGELICA DRIVE
STURTEVANT WI 53177

Officer/Director/Trustee Four

HOWARD PETERSON
DIRECTOR
911 VINE STREET
UNION GROVE WI 53182

Organization’s website
Organization’s email BENEVOLENCEGUARDIANSHIP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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
Signature Title
Signature Date

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