FORM 1023-EZ for CHARLIES WISH ANIMAL RESCUE

Field Data
EIN 47-4328412
Case Number EO-2015181-000055
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHARLIES WISH ANIMAL RESCUE
Organization’s Mailing Address 12684 BROAD ST
City PATASKALA
State OH
ZIP 43062
Accounting period End 12
Primary contact name LAURA CHENG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LAURA CHENG
PRESIDENT
309 GATESHEAD CT
WESTERVILLE OH 43081

Officer/Director/Trustee Two

DWIGHT HARLOR
VICE PRESIDENT
3500 HEADLEY MILLS RD
PATASKALA OH 43062

Officer/Director/Trustee Three

GEORGANNA ACORD
SECRETARY
10504 PLEASANT VALLEY RD
FRAZEYSBURG OH 43822

Officer/Director/Trustee Four

DANIELLE SIDERS
TREASURER
2495 NORTHRIDGE RD
ALEXANDRIA OH 43001

Organization’s website HTTPS://WWW.FACEBOOK.COM/CHARLIESWISHRESCUE
Organization’s email CHARLIESWISHRESCUE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/2015
Organization Incorporation State OH
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: No
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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