FORM 1023-EZ for GIRLS ROCK PINE RIDGE

Field Data
EIN 83-4032691
Case Number EO-2019136-000248
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GIRLS ROCK PINE RIDGE
Organization’s Mailing Address 2237 BIA 27
City PORCUPINE
State SD
ZIP 57772
Accounting period End 4
Primary contact name MAUREEN OBRIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MAUREEN OBRIEN
DIRECTOR
613 N 48TH STREET
OMAHA NE 68132

Officer/Director/Trustee Two

KATE GLOSSOP
DIRECTOR
2237 BIA 27
PORCUPINE SD 57772

Officer/Director/Trustee Three

CARYNA POURIER
TRUSTEE
2237 BIA 27
PORCUPINE SD 57772

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/19
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A25 - Arts Education
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 MAUREEN OBRIEN
Signature Title DIRECTOR
Signature Date 5/14/19

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