FORM 1023-EZ for BATES COUNTY DOG RESCUE

Field Data
EIN 30-0867798
Case Number EO-2015131-000232
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BATES COUNTY DOG RESCUE
Organization’s Mailing Address 13892 NW CR 9312
City AMSTERDAM
State MO
ZIP 64723
Accounting period End 4
Primary contact name SANDY MAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SANDY MAIN
DIRECTOR
13892 NW CR 9312
AMSTERDAM MO 64723

Officer/Director/Trustee Two

RICK BROWN
BOARD OF DIRECTORS
13892 NW CR 9312
AMSTERDAM MO 64723

Officer/Director/Trustee Three

TAMMY MCLANAHAN
SECRETARY
8395 NW HIGH ST
AMSTERDAM MO 64723

Officer/Director/Trustee Four

DALE BISHOP
BOARD OF DIRECTORS
15775 NW CR 3001
ADRIAN MO 64720

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2015
Organization Incorporation State MO
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: No
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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