FORM 1023-EZ for THE MEDFORD DOG PARK CORP

Field Data
EIN 86-3119765
Case Number EO-2021214-000618
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE MEDFORD DOG PARK CORP
Organization’s Mailing Address 107 STATE ST
City MEDFORD
State WI
ZIP 54451
Accounting period End 3
Primary contact name NAOMI HARTL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NAOMI HARTL
BOARD MEMBER
636 E BROADWAY AVE
MEDFORD WI 54451

Officer/Director/Trustee Two

CARLA HUSTAN
BOARD MEMBER
105 N GERSHWIN ST
STETSONVILLE WI 54480

Officer/Director/Trustee Three

LISA KOPP
BOARD MEMBER
1015 W BROADWAY AVE
MEDFORD WY 54451

Organization’s website NA
Organization’s email NAOMI@GREENBEEFLORALS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/2021
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D61 - Animal Training, Behavior
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NAOMI HARTL
Signature Title BOARD MEMBER
Signature Date 7/30/2021

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