FORM 1023-EZ for BLACK CREEK WILDLIFE CENTER

Field Data
EIN 83-1176537
Case Number EO-2019280-000456
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK CREEK WILDLIFE CENTER
Organization’s Mailing Address 1953 TEMA RD
City HARTSVILLE
State SC
ZIP 29550
Accounting period End 12
Primary contact name HOLLY SELLERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLLY SELLERS
DIRECTOR / OFFICER
19
HARTSVILLE SC 29550

Officer/Director/Trustee Two

STEPHANIE BODIFORD
TRUSTEE
1505 BAY RD
HARTSVILLE SC 29550-3092

Officer/Director/Trustee Three

HAYDEN SNYDER
TRUSTEE
122 CHRUCH AVE
HARTSVILLE SC 29550-1592

Officer/Director/Trustee Four

ANDREW BODIFORD
TRUSTEE
1505 BAY RD
HARSVILLE SC 29550-3092

Officer/Director/Trustee Five

TYLER WRIGHT
OFFICER
1953 TEMA RD
HARTSVILLE SC 29550

Organization’s website BLACKCREEKWILDLIFECENTER.ORG
Organization’s email HOLLYSELLERS15@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/18
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A56 - Natural History, Natural Science Museums
Organization’s purpose Charitable: No
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 Yes
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 HOLLY SELLERS
Signature Title DIRECTOR / OFFICER
Signature Date 10/4/19

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