FORM 1023-EZ for NEW LIFE DOG RESCUE INC

Field Data
EIN 47-5341204
Case Number EO-2015294-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NEW LIFE DOG RESCUE INC
Organization’s Mailing Address 7120 COLONIAL LAKE DRIVE
City RIVERVIEW
State FL
ZIP 33578
Accounting period End 12
Primary contact name KRISTEN A PROSSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KRISTEN PROSSEN
PRESIDENT
7120 COLONIAL LAKE DRIVE
RIVERVIEW FL 33578

Officer/Director/Trustee Two

LISA CRUMBLEY
VICE PRESIDENT
15013 LAKE MAURINE DR
ODESSA FL 33556

Officer/Director/Trustee Three

JOSHUA GOMOLLA
SECRETARY
10108 MARONDA DRIVE
RIVERVIEW FL 33578

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2015
Organization Incorporation State FL
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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