FORM 1023-EZ for TRI-STATE PUBLIC RANGE ASSOCIATION

Field Data
EIN 47-3470904
Case Number EO-2016011-000274
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRI-STATE PUBLIC RANGE ASSOCIATION
Organization’s Mailing Address 2815 HOME STREET
City SIOUX CITY
State IA
ZIP 51109-1349
Accounting period End 12
Primary contact name TYLER GRIFFIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TYLER GRIFFIN
CHAIR/CO-TREASURER
2815 HOME STREET
SIOUX CITY IA 51109-1349

Officer/Director/Trustee Two

JEFF REHAN
SECRETARY/CO-TREASURER
2024 SOUTH MAPLE STREET
SIOUX CITY IA 51106-3048

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C34 - Land Resources Conservation
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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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