FORM 1023-EZ for EAST MISSISSIPPI WILDLIFE REHABILITATION INC

Field Data
EIN 46-3167896
Case Number EO-2015175-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EAST MISSISSIPPI WILDLIFE REHABILITATION INC
Organization’s Mailing Address 4506 GAINES WHITE ROAD
City DEKALB
State MS
ZIP 39328
Accounting period End 12
Primary contact name MICHELLE DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHELLE DIXON
PRESIDENT
4506 GAINES WHITE ROAD
DEKALB MS 39328

Officer/Director/Trustee Two

KIMBERLEY WILLIAMS
VICE-PRESIDENT
12088 HWY 494
COLLINSVILLE MS 39325

Officer/Director/Trustee Three

HEATHER BARHAM
SECRETARY
10915 HWY 493
BAILEY MS 39320

Officer/Director/Trustee Four

VIRGINIA VANDERWALKER
TREASURER
1973 NESTER ROAD
DEKALB MS 39328

Organization’s website
Organization’s email EASTMSWILDLIFEREHAB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/2013
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D34 - Wildlife Sanctuary, Refuge
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
Signature Title
Signature Date

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