FORM 1023-EZ for WYOMING HOMELESS COLLABORATIVE

Field Data
EIN 47-2437635
Case Number EO-2014342-000217
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WYOMING HOMELESS COLLABORATIVE
Organization’s Mailing Address 3817 BEECH STREET
City LARAMIE
State WY
ZIP 82070-5334
Accounting period End 6
Primary contact name KARLA MCCLAREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAUL HEIMER
PRESIDENT
710 E GARFIELD ST SUITE 240
LARAMIE WY 82070-3986

Officer/Director/Trustee Two

DONOVAN MCCOMB
TREASURE
104 SOUTH WALCOTT
CASPER WY 82601-2535

Officer/Director/Trustee Three

BRENDA LYTTLE
SECRETARY
2300 CAPITOL AVENUE
CHEYENNE WY 82001-3644

Officer/Director/Trustee Four

JOHN PATTERSON
VOTING MEMBER
200 NORTH DAVID STREET
CASPER WY 82601-1815

Officer/Director/Trustee Five

LARRY BARTTLEBORT
VOTING MEMEBER
5410 BISHOP BLVD
CHEYENNE WY 82009-3338

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2014
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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
Signature Title
Signature Date

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