FORM 1023-EZ for COPPERHEAD HORSE RESCUE

Field Data
EIN 87-1032109
Case Number EO-2021179-000640
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COPPERHEAD HORSE RESCUE
Organization’s Mailing Address 3751 249TH ST NE
City MCKENZIE
State ND
ZIP 58572
Accounting period End 12
Primary contact name BETH KOHLER DIRECTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BETH KOHLER
DIRECTOR
3751 249TH ST NE
MCKENZIE ND 58572

Officer/Director/Trustee Two

MIKE KAPELLA
DIRECTOR
2598 CHARLOTTE DR N
MANDAN ND 58554

Organization’s website WWW.COPPERHEADHORSERESCUE.ORG
Organization’s email COPPERHEADHORSERESCUE@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2021
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 BETH KOHLER
Signature Title DIRECTOR
Signature Date 6/26/2021

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