FORM 1023-EZ for BLACK HILLS ENVIRONMENTAL INSTITUTE

Field Data
EIN 84-5026762
Case Number EO-2020083-000150
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK HILLS ENVIRONMENTAL INSTITUTE
Organization’s Mailing Address 10A GLENDALE LANE
City RAPID CITY
State SD
ZIP 57702
Accounting period End 2
Primary contact name GARTH HUDSON WADSWORTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARTH WADSWORTH
DIRECTOR
10A GLENDALE LANE
RAPID CITY SD 57702

Officer/Director/Trustee Two

ALAN ANDERSON
DIRECTOR
7774 COLUMBINE COURT
RAPID CITY SD 57702

Officer/Director/Trustee Three

LYSANN ZELLER
DIRECTOR
912 9TH STREET - APT 6
RAPID CITY SD 57701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2020
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
Compensation of Officer director trustee Yes
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 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 GARTH WADSWORTH
Signature Title DIRECTOR
Signature Date 3/19/2020

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