FORM 1023-EZ for COASTAL CAROLINA WILDLIFE REHAB INC

Field Data
EIN 35-2478825
Case Number EO-2016229-000012
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COASTAL CAROLINA WILDLIFE REHAB INC
Organization’s Mailing Address 144 NORTHBROOK DRIVE
City WILMINGTON
State NC
ZIP 28405-8473
Accounting period End 12
Primary contact name JENNIFER S LEONARD DIRECTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID S LEONARD
VICE PRESIDENT
144 NORTHBROOK DR
WILMINGTON NC 28405-8473

Officer/Director/Trustee Two

ANNAMARIE L FANN
TRESAUSARY
216 NORTH 23RD
WILMINGTON NC 28405

Officer/Director/Trustee Three

SANDRA C SHIELDS
SECRETARY
24 NORTHWOOD DRIVE
WILMINGTON NC 28405

Officer/Director/Trustee Four

SHARON A BATISELLIE
CONCIL
2408 INTERGORDAN CT
WILMINGTON NC 28411

Officer/Director/Trustee Five

JENNIFER S LEONARD
DIRECTOR PRESIDENT
144 NORTHBROOK DRIVE
WILMINGTON NC 28405-8473

Organization’s website
Organization’s email CCWR2009@LIVE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/2013
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D40 - Veterinary Services
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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