FORM 1023-EZ for HIDDEN HAVEN SERVICE DOG TRAINING INC

Field Data
EIN 47-1059401
Case Number EO-2015082-000308
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIDDEN HAVEN SERVICE DOG TRAINING INC
Organization’s Mailing Address 7501 JEFFERSON PAIGE RD
City SHREVEPORT
State LA
ZIP 71119
Accounting period End 12
Primary contact name CYNTHIA D BROOKS CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RANDAL COBURN
PRESIDENT
7501 JEFFERSON PAIGE RD
SHREVEPORT LA 71119

Officer/Director/Trustee Two

PATRICIA BURKETT
SEC/TREASURER
7501 JEFFERSON PAIGE RD
SHREVEPORT LA 71119

Officer/Director/Trustee Three

RENEE COFIELD
BOARD MEMBER
10160 THORNWOOD
SHREVEPORT LA 71106

Officer/Director/Trustee Four

KATHARINE BURNETT
BOARD MEMBER
10115 LOS ALTOS
SHREVEPORT LA 71115

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/3/2014
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D61 - Animal Training, Behavior
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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