FORM 1023-EZ for HERO DOG RESCUE INC

Field Data
EIN 47-5500271
Case Number EO-2015310-000400
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HERO DOG RESCUE INC
Organization’s Mailing Address 5155 SADDLEBRED LANE
City CUMMING
State GA
ZIP 30028
Accounting period End 12
Primary contact name ALLYSON CROSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALLYSON CROSS
CEO/TREASURER
5155 SADDLEBRED LANE
CUMMING GA 30028

Officer/Director/Trustee Two

ADAM ROTHMAN
CHAIRMAN
115 WIGTON PLACE
ALPHARETTA GA 30004

Officer/Director/Trustee Three

GARY CROSS
VICE CHAIRMAN
5155 SADDLEBRED LANE
CUMMING GA 30028

Officer/Director/Trustee Four

DOUG SHADDICK
SECRETARY
115 WIGTON PLACE
ALPHARETTA GA 30004

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/2015
Organization Incorporation State GA
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 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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