FORM 1023-EZ for BREATHING RIVERS RANCH INC

Field Data
EIN 81-0753320
Case Number EO-2016130-000178
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREATHING RIVERS RANCH INC
Organization’s Mailing Address PO BOX 583
City HURT
State VA
ZIP 24563
Accounting period End 12
Primary contact name CISSY STRUDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CISSY STRUDER
DEVELOPMENT DIRECTOR
PO BOX 583
HURT VA 24563

Officer/Director/Trustee Two

JOE GAUTIER
DIRECTOR OF HOUSING
2111 4TH STREET
BREMERTON WA 98312

Officer/Director/Trustee Three

LINDA JACKSON
DIRECTOR
8690 SOUTH STATE ROAD 59
CLAY CITY IN 47841

Officer/Director/Trustee Four

SONYA DOTY
DIRECTOR
2963 ERIE CANAL ROAD
TERRE HAUTE IN 47802

Officer/Director/Trustee Five

DAWN WILKINSON
ADMINISTRATOR
10812 PHILLIPS STORE RD
BROADWAY VA 22815

Organization’s website BREATHINGRIVERSRANCH.COM
Organization’s email BREATHINGRIVERSRANCH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/5/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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
Signature Title
Signature Date

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