FORM 1023-EZ for HIDE OUT PINES YOUTH RANCH

Field Data
EIN 82-0862236
Case Number EO-2019130-000253
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIDE OUT PINES YOUTH RANCH
Organization’s Mailing Address 1661 HARRIS RD
City SHEFFIELD VILLAGE
State OH
ZIP 44054
Accounting period End 12
Primary contact name ERIKA FABBRO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT DOANE
PRESIDENT
1663 HARRIS RD
SHEFFIELD VILLAGE OH 44054

Officer/Director/Trustee Two

SANDRA MADDOCK
SECRETARY
PO BOX 986
COLUMBIA STATION OH 44028

Officer/Director/Trustee Three

RICHARD WILLIS
BOARD MEMBER
4820 AVON BELDEN RD
AVON OH 44011

Officer/Director/Trustee Four

JAMES BINGHAM
BOARD MEMBER
3301 WILLIAMS CT
AVON OH 44011

Officer/Director/Trustee Five

DANIEL MILLER
BOARD MEMBER
36720 ROYALTON RD
GRAFTON OH 44044

Organization’s website WWW.HIDEOUTPINESRANCH.COM
Organization’s email INFO@HIDEOUTPINESRANCH.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/17
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SCOTT DOANE
Signature Title PRESIDENT
Signature Date 5/8/19

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