FORM 1023-EZ for THE PAYEE SAFETY NET CORPORATION

Field Data
EIN 81-3934788
Case Number EO-2018340-000160
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE PAYEE SAFETY NET CORPORATION
Organization’s Mailing Address 425 W MAIN STREET SUITE 105
City SUN PRAIRIE
State WI
ZIP 53590
Accounting period End 12
Primary contact name FREDRICK BOBO II
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FREDRICK BOBO II
PRESIDENT
425 W MAIN ST STE 105
SUN PRAIRIE WI 53590

Officer/Director/Trustee Two

VALENTINA AHEDO
BOARD MEMBER
4614 JUDY LANE
MADISON WI 53704

Officer/Director/Trustee Three

CAROLYN JARRETT
BOARD MEMBER
5217 RIDGE OAK DRIVE
MADISON WI 53704

Officer/Director/Trustee Four

VURTIS BROWN-WILLIAMS
BOARD MEMBER
685 LOIS DRIVE APT 1
SUN PRAIRIE WI 53590

Officer/Director/Trustee Five

CYNTHIA LARSON
TREASURER
1030 VILLA CIRCLE
SUN PRAIRIE WI 53590

Organization’s website THEPAYEESAFETYNET.ORG
Organization’s email INFO@THEPAYEESAFETYNET.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/3/16
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 Yes
Donation of funds Yes
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 FREDRICK BOBO II
Signature Title PRESIDENT
Signature Date 12/2/18

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