FORM 1023-EZ for CIRCUS WORLD MUSEUM INC

Field Data
EIN 39-0940177
Case Number EO-2016021-000528
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CIRCUS WORLD MUSEUM INC
Organization’s Mailing Address PO BOX 294
City BARABOO
State WI
ZIP 53913
Accounting period End 6
Primary contact name NATHAN PIERCE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAN GABERT
PRESIDENT
PO BOX 294
BARABOO WI 53913

Officer/Director/Trustee Two

MARILYN PARKINSON
VICE PRESIDENT
PO BOX 294
BARABOO WI 53913

Officer/Director/Trustee Three

NATHAN PIERCE
TREASURER
PO BOX 294
BARABOO WI 53913

Officer/Director/Trustee Four

KRIS STABO
SECRETARY
PO BOX 294
BARABOO WI 53913

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/1954
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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