FORM 1023-EZ for A L S ASSISTED LIVING INC

Field Data
EIN 37-1836368
Case Number EO-2017017-000385
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name A L S ASSISTED LIVING INC
Organization’s Mailing Address 4244 N 50TH STREET
City MILWAUKEE
State WI
ZIP 53216
Accounting period End 12
Primary contact name ANITA LANDRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANITA LANDRY
PRESIDENT/CEO
4244 N 50TH STREET
MILWAUKEE WI 53216

Officer/Director/Trustee Two

SHENITA LANDRY
BOARD MEMBER
25 EAST 40TH STREET UNIT 3H
INDIANAPOLIS IN 46205

Officer/Director/Trustee Three

CARL LANDRY
BOARD MEMBER
9716 W JUNIPER STREET
MILWAUKEE WI 53224

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/2016
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P70 - Residential, Custodial Care
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 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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