FORM 1023-EZ for HYPOSTOMUS PLECOSTOMUS COALITION INC

Field Data
EIN 46-4076970
Case Number EO-2016298-000320
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HYPOSTOMUS PLECOSTOMUS COALITION INC
Organization’s Mailing Address P O BOX 675
City MENTMORE
State NM
ZIP 87319
Accounting period End 12
Primary contact name MITCHEL HICKLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MITCHEL HICKLIN
DIRECTOER/PRESIDENT
675
MENTMORE NM 87319

Officer/Director/Trustee Two

SCOTT PENROD
DIRECTOR
1800 RED ROCK DR
GALLUP NM 87301

Officer/Director/Trustee Three

LINDA JEFFRIES
DIRECTOR/SECRETARY/TREASURER
675
MENTMORE NM 87319

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/2013
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S21 - Community Coalitions
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 46-4076970
Case Number EO-2015124-000203
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HYPOSTOMUS PLECOSTOMUS COALITION
Organization’s Mailing Address 675
City MENTMORE
State NM
ZIP 87319-0675
Accounting period End 12
Primary contact name MITCHEL HICKLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MITCHEL HICKLIN
DIRECTOR/PRESIDENT
675
MENTMORE NM 87319

Officer/Director/Trustee Two

SCOTT PENROD
DIRECTOR
1800 RED ROCK DR
GALLUP NM 87301

Officer/Director/Trustee Three

LINDA JEFFRIES
DIRECTOR/SECRETARY/TREASURER
675
GALLUP NM 87301

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/2013
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S21 - Community Coalitions
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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