FORM 1023-EZ for SUNSHINE SENIOR DOG SANCTUARY INC

Field Data
EIN 82-0985494
Case Number EO-2018107-000153
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUNSHINE SENIOR DOG SANCTUARY INC
Organization’s Mailing Address 17258 MALLORYS FORD RD
City GORDONSVILLE
State VA
ZIP 22942
Accounting period End 12
Primary contact name KELLY CHALKLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY CHALKLEY
PRESIDENT
17258 MALLORYS FORD RD
GORDONSVILLE VA 22942

Officer/Director/Trustee Two

BRAD PIZZIMENTI
VICE PRESIDENT
17258 MALLORYS FORD RD
GORDONSVILLE VA 22942

Officer/Director/Trustee Three

MICHELLE FRASER
SECRETARY/TREASURER
13945 TALL TIMBER CT
GAINSESVILLE VA 20155

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/17
Organization Incorporation State VA
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: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 KELLY CHALKLEY
Signature Title PRESIDENT
Signature Date 3/23/18

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