FORM 1023-EZ for TRI-STATE POODLE CLUB OUTREACH INC

Field Data
EIN 46-2646004
Case Number EO-2017228-000384
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRI-STATE POODLE CLUB OUTREACH INC
Organization’s Mailing Address 118 CREST VIEW DR
City POTOSI
State WI
ZIP 53820
Accounting period End 5
Primary contact name RHONDA MENNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA OCONNOR
PRESIDENT
1008 SHADY LANE
DUBUQUE IA 52001

Officer/Director/Trustee Two

KRISTI MURDOCK
VICE PRESIDENT
3213 FEATHER RIDGE RD
TODDVILLE IA 52341

Officer/Director/Trustee Three

RHONDA MENNE
TREASURER
118 CREST VIEW DR
POTOSI WI 53820

Officer/Director/Trustee Four

MARY SKOG
BOARD MEMBER
11029 PALMER RD
DARLINGTON WI 53530

Officer/Director/Trustee Five

ANITA SANDS
BOARD MEMBER
6 OBADIAH
GALENA IL 61036

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/2013
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D03 - Professional Societies, Associations
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 Yes
One Third Support Gifts No
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
EIN 46-2646004
Case Number EO-2015317-000293
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRI-STATE POODLE CLUB OUTREACH INC
Organization’s Mailing Address 11029 PALMER ROAD
City DALRLINGTON
State WI
ZIP 53530
Accounting period End 4
Primary contact name REBECCA OCONNOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

REBECCA OCONNOR
PRESIDENT
1008 SHADY LANE
DUBUQUE IA 52001

Officer/Director/Trustee Two

RHONDA MENNE
TREASURER
118 CRESTVIEW DRIVE
POTOSI WI 53820

Officer/Director/Trustee Three

MARY SKOG
GENERAL BOARD MEMBER
11029 PALMER ROAD
DARLINGTON WI 53530

Officer/Director/Trustee Four

STACY WEIRES
VICE PRESIDENT
2556 1/2 WASHINGTON STREET
DUBUQUE IA 52001

Officer/Director/Trustee Five

DEBORAH GRAF
RESCUE COORDINATOR
1344 LORAS BLVD
DUBUQUE IA 52001

Organization’s website HTTP://TRISTATEPOODLECLUBOUTREACH.WEEBLY.COM/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/2013
Organization Incorporation State WI
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 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 Yes
One Third Support Gifts No
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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