FORM 1023-EZ for ADOPT-A-PAL INC

Field Data
EIN 81-2624939
Case Number EO-2016242-000122
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADOPT-A-PAL INC
Organization’s Mailing Address 113 RIDGECREST ROAD
City GADSDEN
State AL
ZIP 35901
Accounting period End 12
Primary contact name MARK S JANDRLICH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK S JANDRLICH
PRESIDENT
113 RIDGECREST ROAD
GADSDEN AL 35901

Officer/Director/Trustee Two

JO JANDRLICH
VICE PRESIDENT
113 RIDGECREST ROAD
GADSDEN AL 35901

Officer/Director/Trustee Three

CHARLOTTE MELINDA WHITE
SECRETARY
200 BUDDY MURPHREE ROAD
BLOUNTSVILLE AL 35031

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/13/2016
Organization Incorporation State AL
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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