FORM 1023-EZ for NORTHWEST HUMANE SERVICES

Field Data
EIN 84-4020432
Case Number EO-2020059-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTHWEST HUMANE SERVICES
Organization’s Mailing Address 1691 TUCKER RD
City HOOD RIVER
State OR
ZIP 97031
Accounting period End 12
Primary contact name KATHRYN HOLMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHRYN HOLMES
PRESIDENT
1691 TUCKER RD
HOOD RIVER OR 97031

Officer/Director/Trustee Two

EMILIE CLERMONT
SECRETARY
4250 FORDEN RD
HOOD RIVER OR 97031

Officer/Director/Trustee Three

RACHEL CATES
TREASURER
5912 MILL CREEK RD
THE DALLES OR 97058

Organization’s website
Organization’s email NWHUMANE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/2019
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D40 - Veterinary Services
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 Yes
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 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 KATHRYN HOLMES
Signature Title PRESIDENT
Signature Date 2/26/2020

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