FORM 1023-EZ for HI5AFAFA WILDLIFE REHABILITATION SERVICES INC

Field Data
EIN 83-0547206
Case Number EO-2020071-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HI5AFAFA WILDLIFE REHABILITATION SERVICES INC
Organization’s Mailing Address 1049 PALMER AVENUE PO BOX 9438
City NISKAYUNA
State NY
ZIP 12309-5810
Accounting period End 12
Primary contact name NORA GALTO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARAH COULOMBE
PRESIDENT
1049 PALMER AVENUE
NISKAYUNA NY 12309-5810

Officer/Director/Trustee Two

NORA GALTO
SECRETARY/TREASURER
1049 PALMER AVENUE
NISKAYUNA NY 12309-5810

Officer/Director/Trustee Three

SAMANTHA THOMAS
VICE-PRESIDENT
76 RAMSEY PLACE
ALBANY NY 12208

Officer/Director/Trustee Four

DENISE TUFT
BOARD MEMBER
PO BOX 124
ROTTERDAM JUNCTION NY 12150

Officer/Director/Trustee Five

JANNEANE RAFTER
BOARD MEMBER
1187 HILLSIDE AVENUE 4B-37
NISKAYUNA NY 12309

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2019
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D34 - Wildlife Sanctuary, Refuge
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 Yes
Donation of funds Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SARAH COULOMBE
Signature Title PRESIDENT
Signature Date 3/9/2020

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