FORM 1023-EZ for RUSK COUNTY PETS ALIVE

Field Data
EIN 83-1735493
Case Number EO-2018273-000226
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RUSK COUNTY PETS ALIVE
Organization’s Mailing Address 214 SMITH ST
City HENDERSON
State TX
ZIP 75654
Accounting period End 12
Primary contact name KELLI BALLENGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLI BALLENGER
PRESIDENT
214 SMITH ST
HENDERSON TX 75654

Officer/Director/Trustee Two

LISA KING WAUGH
VICE PRESIDENT
1206 EAST MAIN
HENDERSON TX 75652

Officer/Director/Trustee Three

DENISE FAULKNER
SECRETARY
1937 EASTWOOD DR
HENDERSON TX 75652

Organization’s website RUSKCOUNTYPETSALIVE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/16/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 BALLENGER
Signature Title PRESIDENT
Signature Date 9/26/18

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