FORM 1023-EZ for PATRIOT ASSISTANCE DOGS

Field Data
EIN 45-2486498
Case Number EO-2014268-000412
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATRIOT ASSISTANCE DOGS
Organization’s Mailing Address 1478 MALLARD ST
City DETROIT LAKES
State MN
ZIP 56501
Accounting period End 12
Primary contact name NANCY ZEHNACKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAUL GOECKE
PRESIDENT
1336 PELICAN LN
DETROIT LAKES MN 56501

Officer/Director/Trustee Two

MARY JIMMERSON
VICE PRESIDENT
25623 340TH AVE
UNDERWOOD MN 56580

Officer/Director/Trustee Three

NANCY ZEHNACKER
TREASURER
19772 295TH AVE
DETROIT LAKES MN 56501

Officer/Director/Trustee Four

PAM GREGORY
SECRETARY
10408 CO HWY 29
FRAZEE MN 56544

Officer/Director/Trustee Five

LINDA WIEDEWITSCH
TRAINER
20297 309TH AVE
DETROIT LAKES MN 56501

Organization’s website WWW.PATRIOTASSISTANCEDOGS.ORG
Organization’s email PATRIOTASSISTANCEDOGS@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/2011
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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