FORM 1023-EZ for PET CENTRAL HELPS

Field Data
EIN 81-4120839
Case Number EO-2016342-000079
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PET CENTRAL HELPS
Organization’s Mailing Address PO BOX 6091
City BLOOMINGTON
State IL
ZIP 61702
Accounting period End 12
Primary contact name KAREN L FERGUSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA K KITCHENS
PRESIDENT
1007 S MADISON
BLOOMINGTON IL 61701

Officer/Director/Trustee Two

KAREN L FERGUSON
TREASURER
1409 WATERSOUND WAY
BLOOMINGTON IL 61705

Officer/Director/Trustee Three

DIANA L FLYNN
SECRETARY
309 S MISSOURI
MORTON IL 61550

Organization’s website WWW.PETCENTRALHELPS.ORG
Organization’s email INFO@PETCENTRALHELPS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/29/2016
Organization Incorporation State IL
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 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
Signature Title
Signature Date

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