FORM 1023-EZ for MOBILE HEALTH ADVOCACY FOUNDATION INC

Field Data
EIN 82-2951029
Case Number EO-2018257-000520
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOBILE HEALTH ADVOCACY FOUNDATION INC
Organization’s Mailing Address PO BOX 44802
City MADISON
State WI
ZIP 53744-4802
Accounting period End 12
Primary contact name LAURA LAURENZI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURA LAURENZI
CHAIR
PO BOX 44802
MADISON WI 53744-4802

Officer/Director/Trustee Two

MEGAN WILLIAMSON
VICE CHAIR
PO BOX 44802
MADISON WI 53744-4802

Officer/Director/Trustee Three

DENISE SULLIVAN
SECRETARY
PO BOX 44802
MADISON WI 53744-4802

Officer/Director/Trustee Four

WILLIAM STEBBINS
TREASURER
PO BOX 44802
MADISON WI 53744-4802

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/4/17
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 LAURA LAURENZI
Signature Title CHAIR
Signature Date 9/12/18

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