FORM 1023-EZ for SUBLETTE COUNTY CARES

Field Data
EIN 81-3130684
Case Number EO-2016190-000084
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUBLETTE COUNTY CARES
Organization’s Mailing Address 5 PERCUSSION LANE
City PINEDALE
State WY
ZIP 82941
Accounting period End 12
Primary contact name HANK WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRIS BACHELLER
BOARD MEMBER
152 E A STREET
PINEDALE WY 82941-0264

Officer/Director/Trustee Two

HANK WILLIAMS
BOARD MEMBER
5 PERCUSSION LANE
PINEDALE WY 82941-0001

Organization’s website
Organization’s email SUBLETTECOUNTYCARES@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/4/2016
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S19 - Nonmonetary Support N.E.C.
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 Yes
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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