FORM 1023-EZ for HEARTLAND COLLIE RESCUE

Field Data
EIN 47-4534693
Case Number EO-2015306-000454
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEARTLAND COLLIE RESCUE
Organization’s Mailing Address 2450 WEST COUNTRY CLUB ROAD
City CLAREMORE
State OK
ZIP 74019
Accounting period End 7
Primary contact name ANNA PATE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANNA PATE
PRESIDENT
2450 WEST COUNTRY CLUB ROAD
CLAREMORE OK 74019

Officer/Director/Trustee Two

MELISSA SKINNER
VICE PRESIDENT
4871 PIERCE AVE
PAULLINA IA 51046

Officer/Director/Trustee Three

MARY LAVALLEY
SECRETARY
721 BROAD ST
PERKASIE PA 18844

Officer/Director/Trustee Four

SCOTT GIANNELLI
TREASURER
15374 LAKEWOOD COURT
CLAREMORE OK 74017

Officer/Director/Trustee Five

SHEILA GIANNELLI
BOARD MEMBER
15374 LAKEWOOD COURT
CLAREMORE OK 74017

Organization’s website HEARTLANDCOLLIERESCUE.COM
Organization’s email ANNA@HEARTLANDCOLLIERESCUE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/16/2015
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: 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
Signature Title
Signature Date

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