FORM 1023-EZ for 412 ANIMAL RESCUE

Field Data
EIN 83-4332242
Case Number EO-2020016-000356
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 412 ANIMAL RESCUE
Organization’s Mailing Address 529 NORTH AVE
City VERONA
State PA
ZIP 15147
Accounting period End 12
Primary contact name KAREN RODRIGUEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN RODRIGUEZ
MEMBER
526 RIDGE AVENUE
VERONA PA 15147

Officer/Director/Trustee Two

KELLI RODRIGUEZ
MEMBER
529 NORTH AVE
VERONA PA 15147

Organization’s website
Organization’s email KDOR50@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/2019
Organization Incorporation State PA
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KELLI RODRIGUEZ
Signature Title MEMBER
Signature Date 1/14/2020

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