FORM 1023-EZ for BIXBY ANIMAL RESCUE NETWORK

Field Data
EIN 82-1806283
Case Number EO-2017219-000387
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BIXBY ANIMAL RESCUE NETWORK
Organization’s Mailing Address 11063-D SOUTH MEMORIAL DRIVE
City TULSA
State OK
ZIP 74133
Accounting period End 12
Primary contact name APRIL HARGIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWN EVANS
PRESIDENT
17275 SOUTH 90TH EAST AVENUE
BIXBY OK 74008

Officer/Director/Trustee Two

CAROLYN HARRIS
VICE PRESIDENT
603 SOUTH MAIN COURT
BIXBY OK 74008

Officer/Director/Trustee Three

APRIL HARGIS
SECRETARY
17333 SOUTH GARNETT ROAD
BIXBY OK 74008

Officer/Director/Trustee Four

KIM CUPPLES
SECRETARY
18801 SOUTH 43RD WEST AVENUE
MOUNDS OK 74047

Officer/Director/Trustee Five

DENISE ESTES
BOARD MEMBER
5324 SOUTH COLUMBIA PLACE
TULSA OK 74105

Organization’s website NA
Organization’s email BARN74008@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/2017
Organization Incorporation State OK
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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