FORM 1023-EZ for HAIRBALL HAVEN

Field Data
EIN 47-2936943
Case Number EO-2015079-000123
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAIRBALL HAVEN
Organization’s Mailing Address 2760 76TH ST NW
City GLENBURN
State ND
ZIP 58740
Accounting period End 12
Primary contact name SHAUN MENDELSOHN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TANYA TREMBLAY
CHAIRMAN
2760 76TH ST NW
GLENBURN ND 58740

Officer/Director/Trustee Two

TRACEY ROSE
VICE CHAIRMAN
5874 19TH AVE N
NORWICH ND 58678

Officer/Director/Trustee Three

SEAN PFEIL
SECRETARY
109-2 SHERWOOD CIRCLE
MINOT AFB ND 58704

Officer/Director/Trustee Four

SHAUN MENDELSOHN
TREASURER
2760 76TH ST NW
GLENBURN ND 58740

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/2015
Organization Incorporation State ND
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 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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