FORM 1023-EZ for KNOB HILL ANIMAL REFUGE

Field Data
EIN 37-1931276
Case Number EO-2019303-000288
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KNOB HILL ANIMAL REFUGE
Organization’s Mailing Address 216 EAST KNOB HILL RD
City REPUBLIC
State WA
ZIP 99166
Accounting period End 1
Primary contact name SHARON WELLMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON WELLMAN
PRESIDENT
29 WELLMAN RD
REPUBLIC WA 99166

Officer/Director/Trustee Two

JESSE KING
VICE PRESIDENT
716 S PENN IVY DR
MOSES LAKE WA 98837

Officer/Director/Trustee Three

TRAVIS WELLMAN
SECRETARY
135 OLD CEMETERY RD
REPUBLIC WA 99166

Organization’s website
Organization’s email KHAREFUGE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/19
Organization Incorporation State WA
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: Yes
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 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 SHARON WELLMAN
Signature Title PRESIDENT
Signature Date 10/28/19

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