FORM 1023-EZ for C4C

Field Data
EIN 85-0974117
Case Number EO-2020133-000086
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name C4C
Organization’s Mailing Address 24208 SODERBECK RD
City GRANTSBURG
State WI
ZIP 54840
Accounting period End 1
Primary contact name SARAH SCHIEFELBEIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA LAUER
DIRECTOR
411 WISCONSIN DR 103
JEFFERSON WI 53549

Officer/Director/Trustee Two

NICK LAUER
OFFICER
21430 BONNEVILLE RD
GRANTSBURG WI 54840

Officer/Director/Trustee Three

SARAH SCHIEFELBEIN
MANAGER
24208 SODERBECK RD
GRANTSBURG WI 54840

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SARAH SCHIEFELBEIN
Signature Title MANAGER
Signature Date 5/8/2020

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