FORM 1023-EZ for BLACK WALNUT ABBEY FARM SANCTUARY
| Field | Data |
|---|---|
| EIN | 83-4329518 |
| Case Number | EO-2019121-000114 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BLACK WALNUT ABBEY FARM SANCTUARY |
| Organization’s Mailing Address | 820 MILWAUKEE RD |
| City | BELOIT |
| State | WI |
| ZIP | 53511 |
| Accounting period End | 12 |
| Primary contact name | ALEXIS ROSS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ALEXIS ROSS
PRESIDENT
613 S DRYDEN
ARLINGTON HEIGHTS IL 60005
Officer/Director/Trustee Two
ROBERT WAYNER
SECRETARY TREASURER
1445 HIGHLAND
BERWYN IL 60402
Officer/Director/Trustee Three
DARYL SALADAR
DIRECTOR
820 MILWAUKEE AVE
BELOIT WI 53511
| Organization’s website | |
|---|---|
| Organization’s email | BLACKWALNUTABBEYFARMSANCTUARY@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/31/18 |
| Organization Incorporation State | WI |
| 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: Yes Religious: No Educational: Yes 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 | Yes |
| 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 | ALEXIS ROSS |
| Signature Title | PRESIDENT |
| Signature Date | 4/29/19 |
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