FORM 1023-EZ for DES MOINES COUNTY WILDLIFE REHABILITATION INC

Field Data
EIN 83-4037794
Case Number EO-2020030-000279
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DES MOINES COUNTY WILDLIFE REHABILITATION INC
Organization’s Mailing Address 1513 NORTH CENTRAL AVE
City BURLINGTON
State IA
ZIP 52601
Accounting period End 12
Primary contact name TRACY KLATT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACY KLATT
PRESIDENT/DIRECTOR
1513 NORTH CENTRAL AVE
BURLINGTON IA 52601

Officer/Director/Trustee Two

MARGURETTE SEREDA
DIRECTOR
827 HAYES ST
BURLINGTON IA 52601

Officer/Director/Trustee Three

TERESA NEUWEG
DIRECTOR
1505 AVENUE G
FORT MADISON IA 52627

Officer/Director/Trustee Four

KELLY BAMBERG
DIRECTOR
13384 HIDDEN PRAIRIE DR
BURLINGTON IA 52601

Officer/Director/Trustee Five

DAWN FENTON
DIRECTOR
16136 SKUNK RIVER RD
BURLINGTON IA 52601

Organization’s website
Organization’s email DMCWILDLIFEREHAB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2019
Organization Incorporation State IA
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: No
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 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 TRACY KLATT
Signature Title PRESIDENT/DIRECTOR
Signature Date 1/28/2020

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