FORM 1023-EZ for ROCKY MOUNTAIN BIEWER TERRIER CLUBINC

Field Data
EIN 82-5446157
Case Number EO-2018317-000513
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROCKY MOUNTAIN BIEWER TERRIER CLUBINC
Organization’s Mailing Address 30741 RD V6
City DOLORES
State CO
ZIP 81323
Accounting period End 12
Primary contact name KAREN HANSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DALE JOHNSON
TREASURER
296 LAKESHORE DR
DULUTH GA 30096-3030

Officer/Director/Trustee Two

LAVON EULER
VICE PRESIDENT
3851 N RAMSGATE ROAD
MARTINSVILLE ID 46151

Officer/Director/Trustee Three

FAITH BEAM
SECRETARY
1212 RIVERWOOD LANE
SOBIESKI WI 54171-9408

Officer/Director/Trustee Four

KAREN HANSEN
PRESIDENT
30705 RD V6
DOLORES CO 81323

Officer/Director/Trustee Five

VALORIE PRULHIERE
DIRECTOR
4009 EAGLEFLIGHT LANE
LAND O LAKES FL 34639

Organization’s website WWW.ROCKYMOUNTAINBIEWERTERRIERCLUB.COM
Organization’s email INFO@ROCKYMOUNTAINBIEWERTERRIERCLUB.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/18
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: Yes
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 KAREN HANSEN
Signature Title PRESIDENT
Signature Date 11/11/18
EIN 82-5446157
Case Number EO-2018317-000513
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROCKY MOUNTAIN BIEWER TERRIER CLUB INC
Organization’s Mailing Address 30741 RD V6
City DOLORES
State CO
ZIP 81323
Accounting period End 12
Primary contact name KAREN HANSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DALE JOHNSON
TREASURER
296 LAKESHORE DR
DULUTH GA 30096-3030

Officer/Director/Trustee Two

LAVON EULER
VICE PRESIDENT
3851 N RAMSGATE ROAD
MARTINSVILLE ID 46151

Officer/Director/Trustee Three

FAITH BEAM
SECRETARY
1212 RIVERWOOD LANE
SOBIESKI WI 54171-9408

Officer/Director/Trustee Four

KAREN HANSEN
PRESIDENT
30705 RD V6
DOLORES CO 81323

Officer/Director/Trustee Five

VALORIE PRULHIERE
DIRECTOR
4009 EAGLEFLIGHT LANE
LAND O LAKES FL 34639

Organization’s website WWW.ROCKYMOUNTAINBIEWERTERRIERCLUB.COM
Organization’s email INFO@ROCKYMOUNTAINBIEWERTERRIERCLUB.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/18
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: Yes
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 KAREN HANSEN
Signature Title PRESIDENT
Signature Date 11/11/18

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