FORM 1023-EZ for MY BUDDY DOG RESCUE

Field Data
EIN 26-2100480
Case Number EO-2015012-000557
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MY BUDDY DOG RESCUE
Organization’s Mailing Address 1275 DELTA ROAD
City KNIGHTSEN
State CA
ZIP 94548
Accounting period End 12
Primary contact name CAROL STONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROL STONE
PRESIDENT
1275 DELTA ROAD
KNIGHTSEN CA 94548

Officer/Director/Trustee Two

ELLEN BARKLEY
VICE PRESIDENT
1151 SPRINGHAVEN CT
BRENTWOOD CA 94513

Officer/Director/Trustee Three

KIM RALEIGH
TREASURER/SEC
5128 WILLOW CREEK PLACE
ALBUQUERQUE NM 87114

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/2008
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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