FORM 1023-EZ for LAKES AREA LAW DOG FOUNDATION

Field Data
EIN 81-2929407
Case Number EO-2016245-000237
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKES AREA LAW DOG FOUNDATION
Organization’s Mailing Address 12700 SOUTH RACHEL ROAD SW
City FARWELL
State MN
ZIP 56327
Accounting period End 12
Primary contact name CHRIS BARTOSIEWSKI CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MAT KAKAC
PRESIDENT
7281 PARTRIDGE LN SW
ALEXANDRIA MN 56308

Officer/Director/Trustee Two

RICH HOMAN
VICE PRESIDENT
3607 CRESTWOOD DR NE
ALEXANDRIA MN 56308

Officer/Director/Trustee Three

JACKIE LANOUE
SECRETARY TREASURER
12700 SOUTH RACHEL ROAD SW
FARWELL MN 56327

Officer/Director/Trustee Four

ROBERT PEPER
DIRECTOR
986 WOODSMEN DR NE
ALEXANDRIA MN 56308

Officer/Director/Trustee Five

WADE LERFALD
DIRECTOR
3052 BEAUTY POINT RD SW
FARWELL MN 56327

Organization’s website WWW.LAWDOGFOUNDATION.ORG
Organization’s email LAKESAREALAWDOG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2016
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
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 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
Signature Title
Signature Date

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