FORM 1023-EZ for JACKS JOURNEY FOR A DIABETIC ALERT DOG

Field Data
EIN 82-1366139
Case Number EO-2017123-000224
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JACKS JOURNEY FOR A DIABETIC ALERT DOG
Organization’s Mailing Address 42 HOMEWORTH PKWY
City CHEEKTOWAGA
State NY
ZIP 14225
Accounting period End 12
Primary contact name DEBRA DELANEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JILL CAFFERY
PRESIDENT
42 HOMEWORTH PKWY
CHEEKTOWAGA NY 14225

Officer/Director/Trustee Two

FRANCIS CAFFERY
VICE PRESIDENT
42 HOMEWORTH PKEY
CHEEKTOWAGA NY 14225

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/2017
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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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