FORM 1023-EZ for MOUNTAIN STATE THERAPEUTIC HORSEMANSHIP ASSOCIATION

Field Data
EIN 86-3556736
Case Number EO-2021123-000295
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOUNTAIN STATE THERAPEUTIC HORSEMANSHIP ASSOCIATION
Organization’s Mailing Address 661 OPEKISKA RIDGE RD
City FAIRMONT
State WV
ZIP 26554-8689
Accounting period End 12
Primary contact name CAROL PETITTO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROL PETITTO
PRESIDENT
661 OPEKISKA RIDGE R
FAIRMONT WV 26554-8689

Officer/Director/Trustee Two

KAY BARKWILL
TREASURER
5520 ARDEN NOLLVILLE RD
MARTINSBURG WV 25403

Officer/Director/Trustee Three

WINDLE MCQUAIG
SECRETARY
1153 HARTWELL RD
HINTON WV 25951

Officer/Director/Trustee Four

DENVER ALLEN
DIRECTOR
1141 KREPPS ST
MORGANTOWN WV 26505

Officer/Director/Trustee Five

SARAH DORSEY
DIRECTOR
458 HOIST RD
BECKLEY WV 25801

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2021
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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 CAROL PETITTO
Signature Title PRESIDENT
Signature Date 4/29/2021

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