FORM 1023-EZ for BNJ HUSKY RESCUE

Field Data
EIN 81-1942804
Case Number EO-2016123-000185
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BNJ HUSKY RESCUE
Organization’s Mailing Address 147 W ROUTE 66 320
City GLENDORA
State CA
ZIP 91740
Accounting period End 12
Primary contact name JEREMY PERKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEREMY PERKINS
DIRECTOR
5355 128TH AVE
FENNVILLE MI 49408

Officer/Director/Trustee Two

ROBYN DE FUSCO WALLIN
DIRECTOR
4761 W AVE N
QUARTZ HILL CA 93536

Officer/Director/Trustee Three

ADRIANA MCDOWELL
DIRECTOR
426 E COLUMBUS AVE
DES MOINES IA 50315

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/28/2016
Organization Incorporation State CA
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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