FORM 1023-EZ for TEAM MOOSE RESCUE INC

Field Data
EIN 47-5341363
Case Number EO-2018267-000114
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM MOOSE RESCUE INC
Organization’s Mailing Address 1227 NE 40TH TERRACE
City CAPE CORAL
State FL
ZIP 33909-6218
Accounting period End 5
Primary contact name DEBRA MCCOY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBRA MCCOY
PRESIDENT
1227 NE 40TH TERRACE
CAPE CORAL FL 33909-6218

Officer/Director/Trustee Two

JUNE BURNS
VICE PRESIDENT
23397 FREEPORT STREET
PORT CHARLOTTE FL 33971

Officer/Director/Trustee Three

KEVIN MCCOY
TREASURER
1227 NE 40TH TERRACE
CAPE CORAL FL 33909

Officer/Director/Trustee Four

NICHOLE KIKLIS
SECRETARY
23397 FREEPORT STREET
PORT CHARLOTTE FL 33971

Organization’s website WWW.TEAMMOOSERESCUE.ORG
Organization’s email TEAMMOOSERESCUE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/15
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: 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DEBRA MCCOY
Signature Title PRESIDENT
Signature Date 9/20/18
EIN 47-5341363
Case Number EO-2015303-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEAM MOOSE RESCUE INC
Organization’s Mailing Address 3920 30TH AVE SE
City NAPLES
State FL
ZIP 34117
Accounting period End 12
Primary contact name LARA SIMONSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAMMY HENRY
PRESIDENT
2332 CHRISTOPER LANE
CLEWISTON FL 33440

Officer/Director/Trustee Two

KATHY IREY
VICE PRESIDENT
814 N LOPEZ ST
CLEWISTON FL 33440

Officer/Director/Trustee Three

DEBRA MCCOY
SECRETARY
1227 NE 40TH TERRACE
CAPE CORAL FL 33909

Officer/Director/Trustee Four

LARA SIMONSEN
TREASURER
3920 30TH AVE SE
NAPLES FL 34117

Organization’s website TEAMMOOSERESCUE.ORG
Organization’s email TEAMMOOSERESCUE@GMAIL.COM
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: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
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
Signature Title
Signature Date

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