FORM 1023-EZ for FUSION FOUNDATION INC

Field Data
EIN 82-3924321
Case Number EO-2018010-000198
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FUSION FOUNDATION INC
Organization’s Mailing Address 2680 HOWARD COMMONS
City GREEN BAY
State WI
ZIP 54313
Accounting period End 12
Primary contact name RANA POLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANA POLEY
PRESIDENT
2848 LIBAL STREET
GREEN BAY WI 54301

Officer/Director/Trustee Two

LINDSEY KATSETOS
VICE PRESIDENT
1666 BELMONT RD
GREEN BAY WI 54313

Officer/Director/Trustee Three

ALLISON BERTH
SECRETARY TREASURER
2572 HEATHER RD
GREEN BAY WI 54311

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/8/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A62 - Dance
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALLISON BERTH
Signature Title SECRETARY TREASURER
Signature Date 1/8/18

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