FORM 1023-EZ for RIVER VALLEY POLICE K-9 INC

Field Data
EIN 81-3880723
Case Number EO-2016267-000149
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RIVER VALLEY POLICE K-9 INC
Organization’s Mailing Address 907 NIXON ROAD
City LAVACA
State AR
ZIP 72941
Accounting period End 12
Primary contact name KEITH SHELBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICK HITNER
DIRECTOR
5701 SOUTH 28TH ST
FORT SMITH AR 72908

Officer/Director/Trustee Two

JENNIFER MCCONNELL
DIRECTOR
3515 OLD GREENWOOD RD
FORT SMITH AR 72903

Officer/Director/Trustee Three

LARRY SHIFFNER
DIRECTOR
2313 CAMELOT DR
FORT SMITH AR 72903

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2016
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I60 - Law Enforcement Agencies (Police Departments)
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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