FORM 1023-EZ for K9 DIABETES ASSOCIATION INC

Field Data
EIN 81-1570777
Case Number EO-2018109-000641
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name K9 DIABETES ASSOCIATION INC
Organization’s Mailing Address 296 NELSON ST
City MOUNT JACKSON
State VA
ZIP 22842
Accounting period End 6
Primary contact name TRACIE RAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACIE RAY
DIRECTOR
296 NELSON ST
MOUNT JACKSON VA 22842

Officer/Director/Trustee Two

NA NA
NA
NA
NA VA 0

Officer/Director/Trustee Three

NA NA
NA
NA
NA VA 0

Officer/Director/Trustee Four

NA NA
NA
NA
NA VA 0

Officer/Director/Trustee Five

NA NA
NA
NA
NA VA 0

Organization’s website
Organization’s email TRACIE@K9DIABETES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/16
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 TRACIE RAY
Signature Title DIRECTOR
Signature Date 4/17/18

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