FORM 1023-EZ for ANIMAL SHELTER-RESCUE ASSISTANCE PROJECT

Field Data
EIN 81-2101102
Case Number EO-2016102-000349
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANIMAL SHELTER-RESCUE ASSISTANCE PROJECT
Organization’s Mailing Address 22 NORTH VENETIAN WAY
City PORT ORANGE
State FL
ZIP 32127
Accounting period End 12
Primary contact name JASON DUNGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NIKKI DUNGAN
PRESIDENT
22 NORTH VENETIAN WAY
PORT ORANGE FL 32127

Officer/Director/Trustee Two

TERRY FUNDERBURK
VICE PRESIDENT
7350 SW 204TH AVE
DUNNELLON FL 34431

Officer/Director/Trustee Three

SHIRLEY COLE
SECRETARY
3856 SOUTH ATLANTIC AVE
DAYTONA BEACH SHORES FL 32118

Organization’s website
Organization’s email ANIMALSHELTERASSISTANCEPROJECT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/2016
Organization Incorporation State FL
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: No
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 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
Signature Title
Signature Date

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