FORM 1023-EZ for KANSAS POLICE DOG ASSOCIATION

Field Data
EIN 43-1808567
Case Number EO-2015218-000491
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KANSAS POLICE DOG ASSOCIATION
Organization’s Mailing Address PO BOX 271
City AUGUSTA
State KS
ZIP 67010
Accounting period End 12
Primary contact name CHAD MCCLUSKEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAIMON CUNDIFF
PRESIDENT
909 N ANDOVER RD
ANDOVER KS 67002

Officer/Director/Trustee Two

JEREMY HUNSUCKER
VICE PRESIDENT
300 E MAIN ST
INDEPENDENCE KS 67301

Officer/Director/Trustee Three

DALE BURTON
TREASURER
106 NORTH 1ST
WESTMORELAND KS 66549

Officer/Director/Trustee Four

CHAD MCCLUSKEY
REGISTERED AGENT
2100 N OHIO ST
AUGUSTA KS 67010

Organization’s website WWW.KPDA.ORG
Organization’s email CHAD@KPDA.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/1998
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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