FORM 1023-EZ for ADOPT A HUSKY MINNESOTA

Field Data
EIN 82-3056284
Case Number EO-2017296-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADOPT A HUSKY MINNESOTA
Organization’s Mailing Address PO BOX 490641
City BLAINE
State MN
ZIP 55449
Accounting period End 12
Primary contact name KATRINA ST CLAIR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMANDA PAULSON
PRESIDENT AND CHAIR
3213 89TH DRIVE NE
BLAINE MN 55449

Officer/Director/Trustee Two

HEIDI HENRY
TREASURER
717 IONA LANE
ROSEVILLE MN 55113

Officer/Director/Trustee Three

ANN PIWOWARSKI
VICE PRESIDENT
8408 HARKNESS RD S
COTTAGE GROVE MN 55016

Officer/Director/Trustee Four

CASSANDRA ESTERS
SECRETARY
5112 ORIOLE DR
FARMINGTON MN 55024

Officer/Director/Trustee Five

KATRINA ST CLAIR
FUNDRAISING DIRECTOR
10625 JEFFERSON ST NE
BLAINE MN 55434

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/27/2017
Organization Incorporation State MN
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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