FORM 1023-EZ for NGSPA PRAIRIE CHICKEN CHAMPIONSHIPINC

Field Data
EIN 83-1726036
Case Number EO-2019087-000307
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NGSPA PRAIRIE CHICKEN CHAMPIONSHIPINC
Organization’s Mailing Address 50 W BYERS PL
City DENVER
State CO
ZIP 80223
Accounting period End 12
Primary contact name ROBIN LAMBOURN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL PATRICK
CO-PRESIDENT AND DIRECTOR
19784 CR 3
BERTHOUD CO 80513

Officer/Director/Trustee Two

CHAD INDERMAN
CO-PRESIDENT AND DIRECTOR
PO BOX 731
LUBBOCK TX 79408

Officer/Director/Trustee Three

JOHN KADAVY
TREASURER AND DIRECTOR
2021 CLUBHOUSE DRIVE STE 100
GREELEY CO 80634

Officer/Director/Trustee Four

ROBIN LAMBOURN
SECRETARY AND DIRECTOR
50 W BYERS PL
DENVER CO 80223

Officer/Director/Trustee Five

KEITH BRYANT
DIRECTOR
16139 E DORADO CIRCLE
CENTENNIAL CO 80015

Organization’s website N/A
Organization’s email ROBIN.LAMBOURN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 ROBIN LAMBOURN
Signature Title SECRETARY AND DIRECTOR
Signature Date 3/26/19
EIN 83-1726036
Case Number EO-2019087-000307
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NGSPA PRAIRIE CHICKEN CHAMPIONSHIP INC
Organization’s Mailing Address 50 W BYERS PL
City DENVER
State CO
ZIP 80223
Accounting period End 12
Primary contact name ROBIN LAMBOURN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL PATRICK
CO-PRESIDENT AND DIRECTOR
19784 CR 3
BERTHOUD CO 80513

Officer/Director/Trustee Two

CHAD INDERMAN
CO-PRESIDENT AND DIRECTOR
PO BOX 731
LUBBOCK TX 79408

Officer/Director/Trustee Three

JOHN KADAVY
TREASURER AND DIRECTOR
2021 CLUBHOUSE DRIVE STE 100
GREELEY CO 80634

Officer/Director/Trustee Four

ROBIN LAMBOURN
SECRETARY AND DIRECTOR
50 W BYERS PL
DENVER CO 80223

Officer/Director/Trustee Five

KEITH BRYANT
DIRECTOR
16139 E DORADO CIRCLE
CENTENNIAL CO 80015

Organization’s website N/A
Organization’s email ROBIN.LAMBOURN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 ROBIN LAMBOURN
Signature Title SECRETARY AND DIRECTOR
Signature Date 3/26/19

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