FORM 1023-EZ for SHAMUS PROJECT NC

Field Data
EIN 81-4588764
Case Number EO-2017041-000181
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHAMUS PROJECT NC
Organization’s Mailing Address 29 MARQUETTE DRIVE
City RAPID CITY
State SD
ZIP 57701
Accounting period End 12
Primary contact name LILY MENDOZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL PHILLIPS
DIRECTOR
1168 PARKWOOD ROAD
RAPID CTY SD 57701

Officer/Director/Trustee Two

MADGE DUCHENEAUX
DIRECTOR
3337 42ND AVE SOUTH
MINNEAPOLIS MN 55406

Officer/Director/Trustee Three

CAMERON DUCHENEAUX
DIRECTOR
206 FRANKLIN STREET
RAPID CITY SD 57701

Officer/Director/Trustee Four

LILY MENDOZA
ADMINISTRATOR
29 MARQUETTE DRIVE
RAPID CITY SD 57701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/2016
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 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
Signature Title
Signature Date

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