FORM 1023-EZ for PACIFIC WATERFOWL RESCUE

Field Data
EIN 47-5535377
Case Number EO-2015331-000313
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PACIFIC WATERFOWL RESCUE
Organization’s Mailing Address 27272 HARNESS DRIVE
City TEHACHAPI
State CA
ZIP 93561
Accounting period End 12
Primary contact name LORRAINE AUBERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LORRAINE AUBERT
PRESIDENT/DIRECTOR
27272 HARNESS DRIVE
TEHACHAPI CA 93561

Officer/Director/Trustee Two

CONSTANCE THOMPSON
SECRETARY/DIRECTOR
14525 HOLLY SPRINGS DR
HUNTERSVILLE NC 28078

Officer/Director/Trustee Three

CHRISTINE SHERRILL
TREASURER/DIRECTOR
24200 SORREL COURT
TEHACHAPI CA 93561

Officer/Director/Trustee Four

JAMES AUBERT
DIRECTOR
650 WEST C STREET
DIXON CA 95620

Organization’s website
Organization’s email PACIFICWATERFOWLRESCUE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2015
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: 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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