FORM 1023-EZ for CONVERSE COUNTY SFW

Field Data
EIN 83-3603666
Case Number EO-2019060-000345
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONVERSE COUNTY SFW
Organization’s Mailing Address 1954 E RICHARDS ST
City DOUGLAS
State WY
ZIP 82633
Accounting period End 12
Primary contact name JAY L MAGNUSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAY MAGNUSON
PRESIDENT
2407 FERTIG DRIVE
WHEATLAND WY 82201

Officer/Director/Trustee Two

BRIAN JOHNSON
VICE PRESIDENT
405 GLENDO PARK RD
GLENDO WY 82213

Officer/Director/Trustee Three

BRET FREY
TREASURER
201 SANFORD AVE
DOUGLAS WY 82633

Officer/Director/Trustee Four

REX WOOD
SECRETARY
327 N 6TH
DOUGLAS WY 82633

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/19
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D30 - Wildlife Preservation, Protection
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 JAY MAGNUSON
Signature Title PRESIDENT
Signature Date 2/27/19

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