FORM 1023-EZ for WACANTE KIYAPI

Field Data
EIN 82-4887328
Case Number EO-2018089-000397
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WACANTE KIYAPI
Organization’s Mailing Address PO BOX 321
City PINE RIDGE
State SD
ZIP 57770-321
Accounting period End 12
Primary contact name MARK BUTTERBRODT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK BUTTERBRODT
PRESIDENT
PO BOX 568
MARTIN SD 57551-568

Officer/Director/Trustee Two

MARY TOBACCO
TREASURER
PO BOX 321
PINE RIDGE SD 57770-321

Officer/Director/Trustee Three

ANN TOBACCO
SECRETARY
PO BOX 882
PINE RIDGE SD 57770-882

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/18
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARK BUTTERBRODT
Signature Title PRESIDENT
Signature Date 3/28/18

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