FORM 1023-EZ for BLACK SHEEP PROJECT

Field Data
EIN 83-1410876
Case Number EO-2018243-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK SHEEP PROJECT
Organization’s Mailing Address PO BOX 305
City DAYTON
State OR
ZIP 97114
Accounting period End 12
Primary contact name MICHAEL PERRI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL PERRI
SECRETARY TREASURER
PO BOX 305
DAYTON OR 97114

Officer/Director/Trustee Two

JANET COFFMAN
PRESIDENT
4015 NE WINTERS HILL ROAD
DAYTON OR 97114

Officer/Director/Trustee Three

JANET HENDRIKSON
BOARD MEMBER
912 44TH STREET
SACRAMENTO CA 95819

Officer/Director/Trustee Four

ROBERT LAWRENCE
BOARD MEMBER
11726 SW 29TH PLACE
PORTLAND OR 97219

Officer/Director/Trustee Five

TANYA WALLACE-GOBERN
BOARD MEMBER
5329 EDINGTON LANE
RALEIGH NC 27604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/18
Organization Incorporation State OR
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: 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 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 MICHAEL PERRI
Signature Title SECRETARY TREASURER
Signature Date 8/29/18

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