FORM 1023-EZ for JACOB MEMORIAL CHARITABLE TRUST

Field Data
EIN 35-7244212
Case Number EO-2019274-000211
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JACOB MEMORIAL CHARITABLE TRUST
Organization’s Mailing Address PO BOX 484
City GREEN LANE
State PA
ZIP 18054
Accounting period End 12
Primary contact name PAULA JEAN PONTE DVM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULA JEAN PONTE DVM
TRUSTEE
PO BOX 484
GREEN LANE PA 18054

Officer/Director/Trustee Two

JOSEPH DWIGHT VANVALKENBURG VI
TRUSTEE
PO BOX 59
QUAKERTOWN PA 18951

Organization’s website NONE
Organization’s email JACOBBOMBAYS13@GMAIL.COM
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 6/3/19
Organization Incorporation State CO
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: Yes
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 PAULA JEAN PONTE DVM
Signature Title TRUSTEE
Signature Date 9/29/19

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