FORM 1023-EZ for UNEGA MOUNTAIN DOG RESCUE INC

Field Data
EIN 85-2885996
Case Number EO-2021084-000001
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UNEGA MOUNTAIN DOG RESCUE INC
Organization’s Mailing Address PO BOX 2134
City KETCHUM
State ID
ZIP 83340
Accounting period End 12
Primary contact name TIFFANY LARSON-FOUNDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIFFANY LARSON
DIRECTOR
PO BOX 2134
KETCHUM ID 83340

Officer/Director/Trustee Two

GARY TICKNER
DIRECTOR
PO BOX 2134
KETCHUM ID 83340

Officer/Director/Trustee Three

RICHARD GEIGLE
DIRECTOR
PO BOX 2134
KETCHUM ID 83340

Organization’s website UNEGAMOUNTAINDOGRESCUE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2020
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 TIFFANY LARSON
Signature Title DIRECTOR
Signature Date 11/17/2020

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