FORM 1023-EZ for A ROAD TO HOME INC

Field Data
EIN 81-2525915
Case Number EO-2019246-000074
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A ROAD TO HOME INC
Organization’s Mailing Address 106
City SHOSHONE
State ID
ZIP 83352
Accounting period End 12
Primary contact name SUSIE PETERSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANE HOUST
DIRECTOR
POB 72
SHOSHONE ID 83352

Officer/Director/Trustee Two

TONJA DRAKE
PRESIDENT
406 NORTH BIRCH
SHOSHONE ID 83352

Officer/Director/Trustee Three

MARGO HARVEY TAFOYA
VICE PRESIDENT
106 S RAIL E
SHOSHONE ID 83352

Officer/Director/Trustee Four

SUSIE PETERSEN
SECRETARY
106 SOUTH RAIL EAST
SHOSHONE ID 83352

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/20/16
Organization Incorporation State ID
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: Yes
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SUSIE PETERSEN
Signature Title SECRETARY
Signature Date 8/29/19
EIN 81-2525915
Case Number EO-2016243-000110
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name A ROAD TO HOME INC
Organization’s Mailing Address 106 SOUTH RAIL EAST
City SHOSHONE
State ID
ZIP 83352
Accounting period End 12
Primary contact name SUSIE PETERSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIA GRAVES
DIRECTOR
119 RAINBOW DR
JEROME ID 83338

Officer/Director/Trustee Two

TONJA DRAKE
DIRECTOR
406 NORTH EDITH
SHOSHONE ID 83352

Officer/Director/Trustee Three

SUSIE PETERSEN
DIRECTOR
106 SOUTH RAIL EAST
SHOSHONE ID 83352

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/20/2016
Organization Incorporation State ID
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: Yes
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 Yes
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
Signature Title
Signature Date

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