FORM 1023-EZ for MOULTRIE COUNTY ILLINOIS PAWS

Field Data
EIN 84-3225121
Case Number EO-2021091-001020
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOULTRIE COUNTY ILLINOIS PAWS
Organization’s Mailing Address 10 LEISURE ACRES
City SULLIVAN
State IL
ZIP 61951-9404
Accounting period End 12
Primary contact name BETSY MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BETSY MILLER
DIRECTOR
10 LEISURE ACRES
SULLIVAN IL 61951-9404

Officer/Director/Trustee Two

ANGELA CARNES
OFFICER
58 ROLEY ESTATES
SULLIVAN IL 61951-6916

Officer/Director/Trustee Three

KORIN BECKWITH
OFFICER
1226 EAST JACKSON STREET
SULLIVAN IL 61951-1636

Organization’s website
Organization’s email moultriecountypaws@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2021
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related 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 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 BETSY MILLER
Signature Title DIRECTOR
Signature Date 2/21/2021

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