FORM 1023-EZ for ALPHA HUMANE ORGANIZATION

Field Data
EIN 51-0479880
Case Number EO-2014220-000246
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ALPHA HUMANE ORGANIZATION
Organization’s Mailing Address 86 SOUTH COUNTY ROAD 1 EAST
City MONTE VISTA
State CO
ZIP 81144
Accounting period End 6
Primary contact name JANET BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROL ANN BURNET
BOARD MEMBER
2013 CLARKE MOUNTAIN LANE
ANTONITO CO 81120

Officer/Director/Trustee Two

JANET R BLACK
PRESIDENT
THE BRIDGE -75/ 3407 CARROLL STREET
ALAMOSA CO 81101

Officer/Director/Trustee Three

PHYLISS GREY
BOARD MEMBER
PO BOX 1417
ALAMOSA CO 81101

Officer/Director/Trustee Four

DONNA MOON
BOARD MEMBER
PO BOX 9
MOSCA CO 81146

Officer/Director/Trustee Five

MARIANNA KING
BOARD MEMBER
219 DUNHAM
MONTE VISTA CO 81144

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2004
Organization Incorporation State CO
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: Yes
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
Signature Title
Signature Date

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