FORM 1023-EZ for DACHSHUND SEEKING FOREVER HOME RESCUE CORPORATION

Field Data
EIN 83-1511339
Case Number EO-2018255-000219
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DACHSHUND SEEKING FOREVER HOME RESCUE CORPORATION
Organization’s Mailing Address 3506 RAYE ANN DR
City PLANT CITY
State FL
ZIP 33566
Accounting period End 12
Primary contact name TIA BEDNARCYZK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIA BEDNARCYZK
MANAGING DIRECTOR
3506 RAYE ANN DR
PLANT CITY FL 33566

Officer/Director/Trustee Two

CHRISTINE FONTAINE
DIRECTOR
12375 S MILITARY TR UNIT 73
BOYNTON BEACH FL 33436

Officer/Director/Trustee Three

OMAR BELTRAN
DIRECTOR
3906 FALCON DR
MISSION TX 78572

Officer/Director/Trustee Four

MICHAEL ELLINGTON
DIRECTOR
3506 RAYE ANN DR
PLANT CITY FL 33566

Officer/Director/Trustee Five

SONA BUJDAKOVA
DIRECTOR
1060 DELTA DR
ELGIN IL 60123

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/28/18
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: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 TIA BEDNARCYZK
Signature Title MANAGING DIRECTOR
Signature Date 9/10/18

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