FORM 1023-EZ for SAMADHI WILDLIFE INC

Field Data
EIN 85-0601120
Case Number EO-2020101-000186
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMADHI WILDLIFE INC
Organization’s Mailing Address 11-B CARDINAL DR
City ORMOND BEACH
State FL
ZIP 32176
Accounting period End 12
Primary contact name DAWN MARIE BARBONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAWN MARIE BARBONE
PRESIDENT
11-B CARDINAL DR
ORMOND BEACH FL 32176

Officer/Director/Trustee Two

JESSE A HEILMAN
VICE PRESIDENT
297 EUCLID AVE
DAYTONA BEACH FL 32118

Officer/Director/Trustee Three

BETH G HEILMAN
SECRETARY
297 EUCLID AVE
DAYTONA BEACH FL 32118

Officer/Director/Trustee Four

JUDY L RAMOS
TREASURER
1 ROLLINGWOOD TRAIL
ORMOND BEACH FL 32174

Officer/Director/Trustee Five

OLIVER MITROV
DIRECTOR
2727 N ATLANTIC AVE APT 312
DAYTONA BEACH FL 32118

Organization’s website
Organization’s email ALBAMARIA73@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D34 - Wildlife Sanctuary, Refuge
Organization’s purpose Charitable: Yes
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 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 DAWN MARIE BARBONE
Signature Title PRESIDENT
Signature Date 4/8/2020

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