FORM 1023-EZ for KEIFFERS RESCUE CENTER

Field Data
EIN 46-3275052
Case Number EO-2014336-000425
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KEIFFERS RESCUE CENTER
Organization’s Mailing Address 210 E ELLIS ST
City BELDING
State MI
ZIP 48809
Accounting period End 12
Primary contact name DEREK BLOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DEREK BLOK
EXECUTIVE DIRECTOR
210 E ELLIS ST
BELDING MI 48809

Officer/Director/Trustee Two

MARK BEAR
VICE PRESIDENT
210 E ELLIS ST
BELDING MI 48809

Officer/Director/Trustee Three

STEPHANIE DALLMAN
DIRECTOR OF MARKETING
107 DWIGHT AVE SE
GRAND RAPIDS MI 49506

Officer/Director/Trustee Four

DARCEY SOUTHWELL
DIRECTOR OF EVENTS
14200 BAYOU DR
SPRING LAKE MI 49456

Organization’s website WWW.KEIFFERSRESCUECENTER.ORG
Organization’s email KEIFFERANDFRIENDSRESCUE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/16/2013
Organization Incorporation State MI
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 Yes
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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