FORM 1023-EZ for PERKINS COUNTY ANIMAL SHELTER
| Field | Data |
|---|---|
| EIN | 46-4798354 |
| Case Number | EO-2016020-000358 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | PERKINS COUNTY ANIMAL SHELTER |
| Organization’s Mailing Address | 68 SOUTH CENTRAL AVENUE |
| City | GRANT |
| State | NE |
| ZIP | 69140 |
| Accounting period End | 12 |
| Primary contact name | SHANNON JENSEN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
JESSICA BOLLINGER
PRESIDENT
709 LOGAN AVE
GRANT NE 69140
Officer/Director/Trustee Two
SHANNON JENSEN
DIRECTOR
104 WEST HWY 23
GRANT NE 69140
Officer/Director/Trustee Three
CAITLIN PELSTER
MEMBER
PO BOX 561
GRANT NE 69140
Officer/Director/Trustee Four
NICOLE HENDRICKS
MEMBER
MAIN STREET
WALLACE NE 69169
Officer/Director/Trustee Five
SUE DERBY
MEMBER
32280 RD 768
OGALLALA NE 69153
| Organization’s website | |
|---|---|
| Organization’s email | PCANIMALSHELTER@LIVE.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/10/2003 |
| Organization Incorporation State | NE |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | D20 - Animal Protection and Welfare |
| Organization’s purpose | Charitable: No Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | |
| Signature Title | |
| Signature Date |
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