FORM 1023-EZ for NEWCASTLE WYOMING VETERANS MEMORIAL

Field Data
EIN 84-4411561
Case Number EO-2021172-000432
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NEWCASTLE WYOMING VETERANS MEMORIAL
Organization’s Mailing Address PO BOX 842
City NEWCASTLE
State WY
ZIP 82701
Accounting period End 12
Primary contact name DANIEL KEIERLEBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARRELL OTTEMA
PRESIDENT
23402 NORTH HIGHWAY 85
NEWCASTLE WY 82701

Officer/Director/Trustee Two

GREG JAMES
VICE PRESIDENT
503 WEST CAMBRIA STREET
NEWCASTLE WY 82701

Officer/Director/Trustee Three

KASEY KEELER
SECRETARY
200 ROUNDUP AVENUE
NEWCASTLE WY 82701

Officer/Director/Trustee Four

MICK BOHN
DIRECTOR
9 SKYVIEW CIRCLE
NEWCASTLE WY 82701

Officer/Director/Trustee Five

DANIEL KEIERLEBER
DIRECTOR
3321 STIRRUP STREET
NEWCASTLE WY 82701

Organization’s website
Organization’s email DVKEIERLEBER@RTCONNECT.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/2020
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A85 -
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DANIEL KEIERLEBER
Signature Title DIRECTOR
Signature Date 6/17/2021

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