FORM 1023-EZ for MASTER NATIONAL RETRIEVER CLUB FOUNDATION

Field Data
EIN 46-3114401
Case Number EO-2014240-000490
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MASTER NATIONAL RETRIEVER CLUB FOUNDATION
Organization’s Mailing Address PO BOX 444
City COLUMBIA
State TN
ZIP 38402-0444
Accounting period End 12
Primary contact name JAMES B HUGHES JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BILL TEAGUE
DIRECTOR
734 COUNTY ROAD 630
NACOGDOCHES TX 75964

Officer/Director/Trustee Two

JOHN BLACKBIRD
DIRECTOR
1783 JOHNSONS CARTWAY
MORA MN 55051

Officer/Director/Trustee Three

GLORIA MUNDELL
DIRECTOR
829 SOUTH MILLER COURT
LAKEWOOD CO 80226

Officer/Director/Trustee Four

JAMES B HUGHES JR
DIRECTOR
101 BASS DR
COLUMBIA TN 38401

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/2013
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
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 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 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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