FORM 1023-EZ for RISE ANIMAL REFUGE LLC

Field Data
EIN 86-3802080
Case Number EO-2021137-000123
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RISE ANIMAL REFUGE LLC
Organization’s Mailing Address 16400 US HWY 331S SUITE B2 -155
City FREEPORT
State FL
ZIP 32439
Accounting period End 12
Primary contact name YOLANDA ELLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

YOLANDA ELLIS
EXECUTIVE DIRECTOR
16400 US HWY 331S SUITE B2 -155
FREEPORT FL 32439

Officer/Director/Trustee Two

AARON ELLIS
DIRECTOR
16400 US HWY 331S SUITE B2 -155
FREEPORT FL 32439

Officer/Director/Trustee Three

CHASE BARFIELD
DIRECTOR
16400 US HWY 331S SUITE B2 -282
FREEPORT FL 32439

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2021
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: Yes
Cruelty Prevention: No
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 YOLANDA ELLIS
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/12/2021

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