FORM 1023-EZ for CROSSROADS K9 RESCUE INC

Field Data
EIN 81-3246067
Case Number EO-2019343-000495
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CROSSROADS K9 RESCUE INC
Organization’s Mailing Address 839 OAK ROAD
City KRONENWETTER
State WI
ZIP 54455
Accounting period End 12
Primary contact name SEAN M DUMAIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEATHER ZYNDA
DIRECTOR OF OPERATIONS
839 OAK ROAD
KRONENWETTER WI 54455

Officer/Director/Trustee Two

SEAN DUMAIS
DIRECTOR OF TRAINING
839 OAK ROAD
KRONENWETTER WI 54455

Officer/Director/Trustee Three

BECKY HENSEL
DIRECTOR OF MARKETING
839 OAK ROAD
KRONENWETTER WI 54455

Officer/Director/Trustee Four

JENNY KNUTSON
BOARD MEMBER
839 OAK ROAD
KRONENWETTER WI 54455

Officer/Director/Trustee Five

PETE PREU
BOARD MEMBER
839 OAK ROAD
KRONENWETTER WI 54455

Organization’s website CROSSROADSK9RESCUE.ORG
Organization’s email SEAN@CROSSROADSK9RESCUE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2016
Organization Incorporation State WI
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SEAN DUMAIS
Signature Title DIRECTOR OF TRAINING
Signature Date 12/6/2019
EIN 81-3246067
Case Number EO-2016201-000320
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CROSSROADS K9 RESCUE INC
Organization’s Mailing Address 1777 KOWALSKI ROAD
City KRONENWETTER
State WI
ZIP 54455
Accounting period End 12
Primary contact name HEATHER ZYNDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEATHER ZYNDA
DIRECTOR OF OPERATIONS
1777 KOWALSKI RD
KRONENWETTER WI 54455

Officer/Director/Trustee Two

SEAN DUMAIS
DIRECTOR OF TRAINING
1777 KOWALSKI RD
KRONENWETTER WI 54455

Officer/Director/Trustee Three

OLIVIA ZYNDA
DIRECTOR OF ANIMAL HEALTH
1777 KOWALSKI ROAD
KRONENWETTER WI 54455

Organization’s website
Organization’s email EMTRN2010@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2016
Organization Incorporation State WI
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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