FORM 1023-EZ for PAWESOME VILLAGE RESCUE

Field Data
EIN 47-4202099
Case Number EO-2015166-000232
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PAWESOME VILLAGE RESCUE
Organization’s Mailing Address 10047 FOX SQUIRREL DR
City NEW PORT RICHEY
State FL
ZIP 34654-3576
Accounting period End 6
Primary contact name CINDY BALLARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHARON SMITH
VICE PRESIDENT
2715 BEECH GROVE LANE
WESLEY CHAPEL FL 33544-8738

Officer/Director/Trustee Two

ANNETTE GARBIN
SECRETARY
12020 DUDA LANE
HUDSON FL 34667

Officer/Director/Trustee Three

CINDY BALLARD
CEO
10047 FOX SQUIRREL DR
NEW PORT RICHEY FL 34654-3576

Officer/Director/Trustee Four

VIVIAN SIMER
ADOPTION COORDINATOR
MEREDITH PL
PLANT CITY FL 33563

Officer/Director/Trustee Five

KELLY WALTER
HUMANE CARE EDUCATOR
7260 SANDS CT
SPRING HILL FL 34606

Organization’s website
Organization’s email PAWESOMEVILLAGE@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
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 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 Yes
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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