FORM 1023-EZ for DARK STAR WILDLIFE CENTER

Field Data
EIN 46-5112819
Case Number EO-2015009-000278
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DARK STAR WILDLIFE CENTER
Organization’s Mailing Address 18743 COUNTY ROAD 12
City PENGILLY
State MN
ZIP 55775
Accounting period End 12
Primary contact name JODY BENOLKEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JODY BENOLKEN
EXECUTIVE DIRECTOR
18743 COUNTY ROAD 12
PENGILLY MN 55775

Officer/Director/Trustee Two

DORAN PETERSON
PRESIDENT
18743 COUNTY ROAD 12
PENGILLY MN 55775

Officer/Director/Trustee Three

ANNA MAE BENOLKEN
TREASURER
21843 COUNTY ROAD 17
COHASSET MN 55721

Officer/Director/Trustee Four

MAGGIE GJERDAHL
SECRETARY
2417 - 4TH AVENUE EAST
HIBBING MN 55746

Officer/Director/Trustee Five

SUSAN GROOMS
BOARD MEMBER
21843 COUNTY ROAD 17
COHASSET MN 55721

Organization’s website WWW.DARKSTARWILDLIFECENTER.COM
Organization’s email DARKSTARWILDLIFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/2014
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
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 Yes
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
Signature Title
Signature Date

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