FORM 1023-EZ for SOUTH CENTRAL ILLINOIS LAW DOGS

Field Data
EIN 36-4822196
Case Number EO-2015351-000222
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH CENTRAL ILLINOIS LAW DOGS
Organization’s Mailing Address 68 EAST 1175 AVENUE
City MULBERRY GROVE
State IL
ZIP 62262
Accounting period End 12
Primary contact name MARC LANE WASCHLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARC WASCHLE
PRESIDENT
68 EAST 1175 AVENUE
MULBERRY GROVE IL 62262

Officer/Director/Trustee Two

DALE SARGINSON
VICE PRESIDENT
211 EAST 5TH
SMITHBORO IL 62284

Officer/Director/Trustee Three

BRETT HAAS
SECRETARY
18200 WATER TOWER RD
CARLYLE IL 62231

Officer/Director/Trustee Four

JOSE ROSADO
TREASURER
130 LAKE VISTA
CARLYLE IL 62231

Officer/Director/Trustee Five

TED KOONCE
SGT AT ARMS
2250 NORTH 000 STREET
FILLMORE IL 62032

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 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 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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