FORM 1023-EZ for BY THE LIGHT OF THE MOON

Field Data
EIN 83-2749795
Case Number EO-2019178-000068
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BY THE LIGHT OF THE MOON
Organization’s Mailing Address 918 MONTROSE PKWY
City NORCROSS
State GA
ZIP 30092
Accounting period End 12
Primary contact name SARA SMITH COO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARA SMITH
CHEIF OPERATING OFFICER
918 MONTROSE PKWY
NORCROSS GA 30092

Officer/Director/Trustee Two

DOMINIC TUSA
TREASURER
918 MONTROSE PKWY
NORCROSS GA 30092

Officer/Director/Trustee Three

ANGIE DYSON
CHAIRPERSON
122 DOCS CREEK COURT
NORCROSS GA 30071

Organization’s website N/A
Organization’s email GYPSYMOONPETSERVICES@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/18
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: No
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 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 SARA SMITH
Signature Title CHEIF OPERATING OFFICER
Signature Date 6/25/19

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