FORM 1023-EZ for BLACK HAWK HILL HORSE PARK INC

Field Data
EIN 81-4743509
Case Number EO-2017039-000057
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK HAWK HILL HORSE PARK INC
Organization’s Mailing Address N1760 HWY 45 S
City ANTIGO
State WI
ZIP 54409
Accounting period End 12
Primary contact name SHAUGHN NOVY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAUGHN NOVY
PRESIDENT
N1760 HWY 45 S
ANTIGO WI 54409

Officer/Director/Trustee Two

DONNA WOLF
SECRETARY
W9945 HWY 47
ANTIGO WI 54409

Officer/Director/Trustee Three

DARLENE ECKERMAN
TREASURER
N681 S ROLLWOOD ROAD
ANTIGO WI 54409

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/19/2016
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
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 Yes
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
Signature Title
Signature Date

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