FORM 1023-EZ for MP3 FARMS PET SANCTUARY

Field Data
EIN 81-0955386
Case Number EO-2016025-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MP3 FARMS PET SANCTUARY
Organization’s Mailing Address 235 REUBEN-BOISE RD
City DALLAS
State OR
ZIP 97338-9009
Accounting period End 12
Primary contact name GWYNN HALLBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GWYNN HALLBERG
PRESIDENT
235 REUBEN BOISE RD
DALLAS OR 97338-9009

Officer/Director/Trustee Two

DEREK DEARMENT
SECRETARY
235 REUBEN BOISE RD
DALLAS OR 97338-9009

Officer/Director/Trustee Three

ALISHA PREWITT
BOARD MEMBER
1285 SE MILLER AVE
DALLAS OR 97338

Officer/Director/Trustee Four

MARY SUE ORHAM
BOARD MEMBER
5126 COURTLYN ST NE
KEIZER OR 97303

Officer/Director/Trustee Five

RON THEIS
BOARD MEMBER
5962 BURGUNDY DR
CORVALLIS OR 97330

Organization’s website MP3FARMS.ORG
Organization’s email MISFITS@MP3FARMS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/29/2015
Organization Incorporation State OR
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: Yes
Religious: No
Educational: No
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
Signature Title
Signature Date

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