FORM 1023-EZ for HART EQUINE THERAPY CENTER INC

Field Data
EIN 46-4394613
Case Number EO-2014223-000169
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HART EQUINE THERAPY CENTER INC
Organization’s Mailing Address 10198 BROOKSIDE RD
City AUBURNDALE
State WI
ZIP 54412
Accounting period End 12
Primary contact name KIMBERLY A SIEVERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KIMBERLY SIEVERS
EXECUTIVE DIRECTOR
10198 BROOKSIDE RD
AUBURNDALE WI 54412

Officer/Director/Trustee Two

ASHLEY DETTERBECK-STAUBER
PRESIDENT
11445 MILL CREEK DR
MARSHFIELD WI 54449

Officer/Director/Trustee Three

MARILYN DEAN
VICE PRESIDENT
C3800 HEARTLAND HILLS RD
STRATFORD WI 54484

Officer/Director/Trustee Four

AMY VANWYHE
TREASURER
3993 YELLOWSTONE RD
MILLADORE WI 54454

Officer/Director/Trustee Five

RACHEL GLAZA
SECRETARY
506 ASHLAND AVE
NEKOOSA WI 54457

Organization’s website HARTETC.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N69 - Equestrian, Riding
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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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