FORM 1023-EZ for UNITED STATES SCHIPPERKE CLUB INC

Field Data
EIN 20-5514111
Case Number EO-2016130-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNITED STATES SCHIPPERKE CLUB INC
Organization’s Mailing Address 27 SAMPLY LANE
City HUNTLY
State VA
ZIP 22640
Accounting period End 12
Primary contact name DON NIELSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHARON FURR
PRESIDENT
1174 S KABA ST
NORTH PORT FL 34288-5510

Officer/Director/Trustee Two

DON NIELSEN
VICE-PRESIDENT
27 SAMPY LANE
HUNTLY VA 22640-3118

Officer/Director/Trustee Three

DIAN TAMAS
SECRETARY
4860 KENAI AVE
ANCHORAGE AK 99508-2329

Officer/Director/Trustee Four

LEO HAUSER
TREASURER
300 CAROLINA AVE
SAINT CLOUD FL 34769-2412

Organization’s website WWW.USSCHIPCLUB.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/2006
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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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