FORM 1023-EZ for WINDY HILL DOG HAVEN

Field Data
EIN 81-4545843
Case Number EO-2017166-000085
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WINDY HILL DOG HAVEN
Organization’s Mailing Address 28734 VOTING HOUSE RD
City GREEN RIDGE
State MO
ZIP 65332
Accounting period End 12
Primary contact name DELINDA BENEKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DELINDA BENEKE
PRESIDENT
2865 SOUTHGATE LOOP
SEDALIA MO 65301

Officer/Director/Trustee Two

PHYLLIS ATKIN
TRESASURE
28734 VOTING HOUSE
GREEN RIDGE MO 65332

Officer/Director/Trustee Three

CELESTE FILIS
SECRETARY
1820 MURPHY LANE
SEDALIA MO 65301

Organization’s website HTTP://WWW.ADOPTAPET.COM/WINDY-HILL-DOG-HAVEN/
Organization’s email PETSLIVE03@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/31/2016
Organization Incorporation State MO
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: No
Religious: No
Educational: No
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 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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