FORM 1023-EZ for WESTERN SOUTH DAKOTA CHILD PROTECTION COUNCIL

Field Data
EIN 46-0373882
Case Number EO-2020021-000483
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WESTERN SOUTH DAKOTA CHILD PROTECTION COUNCIL
Organization’s Mailing Address PO BOX 2440
City RAPID CITY
State SD
ZIP 57709-2440
Accounting period End 6
Primary contact name CARISA GERVING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARISA GERVING
PRESIDENT
6762 E DAISY DRIVE
BLACK HAWK SD 57718

Officer/Director/Trustee Two

AMBER KEMP
VICE PRESIDENT
4825 ELMER STREET
RAPID CITY SD 57703

Officer/Director/Trustee Three

DAN WARDLE
TREASURER
515 SWALLOW DRIVE
BOX ELDER SD 57719

Officer/Director/Trustee Four

SARAH CRAWFORD
SECRETARY
2507 ELM AVENUE
RAPID CITY SD 57701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/1983
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I72 - Child Abuse, Prevention of
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CARISA GERVING
Signature Title PRESIDENT
Signature Date 1/17/2020

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