FORM 1023-EZ for PIATT COUNTY ANIMAL SHELTER

Field Data
EIN 46-0855483
Case Number EO-2017283-000393
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PIATT COUNTY ANIMAL SHELTER
Organization’s Mailing Address 306 N BUCHANAN
City MONTICELLO
State IL
ZIP 61856
Accounting period End 12
Primary contact name LEANN TOPOL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANA MCPHEETERS
PRESIDENT
306 N BUCHANAN
MONTICELLO IL 61856

Officer/Director/Trustee Two

SUSAN HALL
SECRETARY
1164 LAURA DR
MONTICELLO IL 61856

Officer/Director/Trustee Three

LEANN TOPOL
TRESURER
1281 N 500 EAST RD
MONTICELLO IL 61856

Officer/Director/Trustee Four

WENDY DOTSON
BOARD MEMBER
18 1/2 EAST WASHINGTON
MONTICELLO IL 61856

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/2012
Organization Incorporation State IL
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 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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