FORM 1023-EZ for BLUE ROBIN PET RESCUE INC

Field Data
EIN 47-3849395
Case Number EO-2015120-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE ROBIN PET RESCUE INC
Organization’s Mailing Address 143 VELIE ROAD
City LAGRANGEVILLE
State NY
ZIP 12540
Accounting period End 12
Primary contact name KRISTIN POMPILIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KRISTIN POMPILIO
PRESIDENT
143 VELIE RD
LAGRANGEVILLE NY 12540

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/2015
Organization Incorporation State NY
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: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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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