FORM 1023-EZ for ANIMAL CARE ASSISTANCE PROGRAM

Field Data
EIN 47-3991716
Case Number EO-2015153-000327
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANIMAL CARE ASSISTANCE PROGRAM
Organization’s Mailing Address 1593 CHALKLEVEL RD
City LOUISA
State VA
ZIP 23093
Accounting period End 12
Primary contact name SUSAN LEVI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUSAN LEVI
BOARD CHAIR
1593 CHALKLEVEL RD
LOUISA VA 23093

Officer/Director/Trustee Two

ANA JOHNSTON
VICE CHAIR
601 WYNGATE DR
FREDERICK MD 21701

Officer/Director/Trustee Three

DOMINIQUE MCLAUGHLIN
SECRETARY
146 WAGNER FARM RD
LOUISA VA 23093

Officer/Director/Trustee Four

PATRICIA MEEHEN
TREASURER
124 HOPEFUL CHURCH LN
BUMPASS VA 23024

Organization’s website
Organization’s email ANIMALCAREPROGRAM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2015
Organization Incorporation State VA
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: Yes
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 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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