FORM 1023-EZ for HINCKLEY RETRIEVER CLUB

Field Data
EIN 47-4711891
Case Number EO-2016138-000261
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HINCKLEY RETRIEVER CLUB
Organization’s Mailing Address 52495 335TH ST
City GROVE CITY
State MN
ZIP 56243
Accounting period End 12
Primary contact name CHRIS W NEU EA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHUCK BECKMANN
PRESIDENT
15287 MADISON ST
HAM LAKE MN 55304

Officer/Director/Trustee Two

JACK HOFFMANN
VICE PRESIDENT
50446 BAYSIDE CIRCLE
RUSH CITY MN 55069

Officer/Director/Trustee Three

SONIA LIEDMAN
SECRETARY TREASURER
52495 335TH ST
GROVE CITY MN 56243

Officer/Director/Trustee Four

ROBERT JORGENSON
MEMBER AT LARGE
41433 FISHTAIL RD
HINCKLEY MN 55037

Officer/Director/Trustee Five

RALPH DOOLEY
MEMBER AT LARGE
6907 W BROADWAY AVE
FOREST LAKE MN 55025

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D61 - Animal Training, Behavior
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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