FORM 1023-EZ for BLACK DOG ANIMAL FUND

Field Data
EIN 47-3631401
Case Number EO-2015149-000352
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK DOG ANIMAL FUND
Organization’s Mailing Address 156 CARLETON AVE
City GLEN ELLYN
State IL
ZIP 60137
Accounting period End 12
Primary contact name ROBIN WOOD- PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBIN WOOD
PRESIDENT/BOARD MEMBER
156 CARLETON AVE
GLEN ELLYN IL 60137

Officer/Director/Trustee Two

RYAN KAISER
GENERAL COUNSEL/BOARD MEMBER
156 CARLETON AVE
GLEN ELLYN IL 60137

Officer/Director/Trustee Three

CRAIG KAISER
BOARD MEMBER
156 CARLETON AVE
GLEN ELLYN IL 60137

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/2015
Organization Incorporation State IL
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: Yes
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 Yes
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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