FORM 1023-EZ for KANINE SIX SANCTUARY

Field Data
EIN 84-5021408
Case Number EO-2020198-000177
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KANINE SIX SANCTUARY
Organization’s Mailing Address 8725 312TH AVE
City BURLINGTON
State WI
ZIP 53105
Accounting period End 12
Primary contact name NICOLE MOSTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE MOSTA
PRESIDENT
8725 312TH AVE
BURLINGTON WI 53105

Officer/Director/Trustee Two

CARREN CORCORAN
VICE PRESIDENT
313 S FRANKLING ST
VERONA WI 53593

Officer/Director/Trustee Three

JILL HALLIN
SECRETARY
21051 188TH AVE
RENTON WA 98058

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2020
Organization Incorporation State WI
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: 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 No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 NICOLE MOSTA
Signature Title PRESIDENT
Signature Date 7/14/2020

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