FORM 1023-EZ for MOSS FOREST SANCTUARY

Field Data
EIN 81-3491066
Case Number EO-2016277-000344
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOSS FOREST SANCTUARY
Organization’s Mailing Address 87464 HIGHWAY 202
City ASTORIA
State OR
ZIP 97103
Accounting period End 12
Primary contact name JENI GALLAGHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENI GALLAGHER
DIRECTOR
87464 HIGHWAY 202
ASTORIA OR 97103

Officer/Director/Trustee Two

JESSICA FEINMAN
SECRETARY
7534 SW VIEW POINT TERRACE
PORTLAND OR 97219

Organization’s website WWW.MOSSFOREST.ORG
Organization’s email JENI@MOSSFOREST.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/2016
Organization Incorporation State OR
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: No
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 Yes
Unrelated Gross Income $1,000 or More Yes
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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