FORM 1023-EZ for NO PET LEFT BEHIND

Field Data
EIN 81-3265445
Case Number EO-2016202-000288
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NO PET LEFT BEHIND
Organization’s Mailing Address 1444 ANGEL CREST DR
City MEDFORD
State OR
ZIP 97504
Accounting period End 12
Primary contact name PAULINE REDON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULINE REDON
PRESIDENT
1444 ANGEL CREST DR
MEDFORD OR 97504

Officer/Director/Trustee Two

SUMMER HUNT
VICE PRESIDENT
3190 TIMOTHY AVE
MEDFORD OR 97504

Officer/Director/Trustee Three

RHONDA FENRICH
BOARD MEMBER
4020 BAILEY VIEW DR
EUGENE OR 97405

Officer/Director/Trustee Four

TAMMY ICENHOWER
BOARD MEMBER
1130 GATE PARK DR
CENTRAL POINT OR 97502

Officer/Director/Trustee Five

MELANIE HOWARD
BOARD MEMBER
2040 SOUTH STAGE RD
MEDFORD OR 97501

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/25/2016
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 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
Signature Title
Signature Date

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