FORM 1023-EZ for MINNESOTA PET LODGE CORP

Field Data
EIN 84-4167084
Case Number EO-2020093-000169
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MINNESOTA PET LODGE CORP
Organization’s Mailing Address 5108 W 74TH ST
City MINNEAPOLIS
State MN
ZIP 55435
Accounting period End 12
Primary contact name ASHLEY VANDERBUSH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEY VANDERBUSH
PRESIDENT/OPER MANAG/DIR
7141 FRANCE AVE S APT 106
EDINA MN 55435

Officer/Director/Trustee Two

WES VANDERBUSH
TREASURER/DIRECTOR
216 PRAIRIEWOOD DR
FARGO ND 58103

Officer/Director/Trustee Three

ERIK WICKLUND
SECRETARY/DIRECTOR
7141 FRANCE AVE S APT 106
VANDERBUSH MN 55435

Organization’s website MINNESOTAPETLODGE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/6/2020
Organization Incorporation State MN
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: 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 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ASHLEY VANDERBUSH
Signature Title PRESIDENT/OPER MANAG/DIR
Signature Date 3/31/2020

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