FORM 1023-EZ for LHC CANINE RESCUE

Field Data
EIN 86-2799473
Case Number EO-2021100-000788
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LHC CANINE RESCUE
Organization’s Mailing Address 1100 LONDON BRIDGE RD STE F106
City LAKE HAVASU CITY
State AZ
ZIP 86406
Accounting period End 3
Primary contact name JASON ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE BURCHELL
PRESIDENT
1041 MCCULLOCH BLVD S
LAKE HAVASU CITY AZ 86406

Officer/Director/Trustee Two

JASON ANDERSON
VICE PRESIDENT
543 COUNTRY CLUB DR B336
SIMI VALLEY CA 93065

Officer/Director/Trustee Three

SHARON ANDERSON
TREASURER
2236 ATHENS AVENUE
SIMI VALLEY CA 93065

Organization’s website BFFRESCUE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2021
Organization Incorporation State AZ
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: 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JASON ANDERSON
Signature Title VICE PRESIDENT
Signature Date 3/26/2021

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