FORM 1023-EZ for GIVE BACK MADISON INCORPORATED

Field Data
EIN 82-3865106
Case Number EO-2018130-000117
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GIVE BACK MADISON INCORPORATED
Organization’s Mailing Address 6701 FAIRHAVEN ROAD APT 301
City MADISON
State WI
ZIP 53719
Accounting period End 12
Primary contact name CHRIS HOFFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRIS HOFFMAN
PRESIDENT AND DIRECTOR
6701 FAIRHAVEN ROAD APT 301
MADISON WI 53719

Officer/Director/Trustee Two

MICHELLE SALAS
SECRETARY AND DIRECTOR
5314 N COOK STREET
MCFARLAND WI 53558

Officer/Director/Trustee Three

RYAN MARX
TREASURER AND DIRECTOR
5813 IDLEDALE CIRCLE
MADISON WI 53711

Officer/Director/Trustee Four

TERESA SCHUDROWITZ
DIRECTOR
436 PARK VIEW ROAD
DEERFIELD WI 53531

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/17
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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 CHRIS HOFFMAN
Signature Title PRESIDENT AND DIRECTOR
Signature Date 5/7/18

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