FORM 1023-EZ for CHINESE SHAR-PEI RESCUE TRUST

Field Data
EIN 82-4910317
Case Number EO-2018106-000804
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHINESE SHAR-PEI RESCUE TRUST
Organization’s Mailing Address 466 BLAISDELL DR
City DELAWARE
State OH
ZIP 43015
Accounting period End 12
Primary contact name JOEL KALEVA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBBY SMITH
PRESIDENT DIRECTOR
2203 WALNUT GROVE DR
RICHMOND TX 77469

Officer/Director/Trustee Two

PAULA BURKHOLDER
TREASURER DIRECTOR
466 BLAISDELL DR
DELAWARE OH 43015

Officer/Director/Trustee Three

ALICE FIX
SECRETARY DIRECTOR
1668 S KINGSTON ST
AURORA CO 80012

Officer/Director/Trustee Four

DON GILLETTE
DIRECTOR
80 BARENT WINNE RD
SELKIRK NY 12158

Officer/Director/Trustee Five

MICHAEL BARKER
DIRECTOR
7739 SCHAFER RD
BOZEMAN MT 59715

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/18
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
Organization’s purpose Charitable: Yes
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 PAULA BURKHOLDER
Signature Title TREASURER DIRECTOR
Signature Date 4/3/18

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