FORM 1023-EZ for PACK LYFE RESCUE INC

Field Data
EIN 86-2134552
Case Number EO-2021162-000054
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PACK LYFE RESCUE INC
Organization’s Mailing Address 249 W JACKSON STREET -406
City HAYWARD
State CA
ZIP 94544
Accounting period End 12
Primary contact name PRISCILLA FERNANDEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PRISCILLA FERNANDEZ
PRES&TREAS&DIRECT&OWNER
249 W JACKSON STREET -406
HAYWARD CA 94544

Officer/Director/Trustee Two

JUNITA RUPAN
SECRETARY
27425 LYFORD ST
HAYWARD CA 94544

Officer/Director/Trustee Three

MANJU PAYNTER
CFO
3821 WATERFALL WAY APT 3821
SAN LEANDRO CA 94578

Organization’s website
Organization’s email PACKLYFERESCUE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/14/2021
Organization Incorporation State CA
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: 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 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PRISCILLA FERNANDEZ
Signature Title PRES&TREAS&DIRECT&OWNER
Signature Date 6/9/2021

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