FORM 1023-EZ for PIT BULL RESCUE CENTRAL

Field Data
EIN 91-2006847
Case Number EO-2018109-000743
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PIT BULL RESCUE CENTRAL
Organization’s Mailing Address 312 SW GREENWICH DR UNIT 318
City LEES SUMMIT
State MO
ZIP 64082
Accounting period End 12
Primary contact name ADAM ROUBITCHEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MERRY YOUNG
PRESIDENT
70 CLEARPOND RD
LAKEVILLE MA 2347

Officer/Director/Trustee Two

CYNTHIA POLITE
VICE PRESIDENT
124 LONG HILL RD
SOUTH WINDSOR CT 6074

Officer/Director/Trustee Three

ADAM ROUBITCHEK
TREASURER
1951 N WILMOT AVE
CHICAGO IL 60647

Officer/Director/Trustee Four

JENNY KETCHUM
SECRETARY
130 MAIN ST
WEST UPTON MA 1568

Officer/Director/Trustee Five

MEGAN ALEXANDER
BOARD MEMBER
1301 QUARRY CT 112
POINT RICHMOND CA 94801

Organization’s website WWW.PBRC.NET
Organization’s email ADAM@PBRC.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/99
Organization Incorporation State MO
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ADAM ROUBITCHEK
Signature Title TREASURER
Signature Date 4/17/18

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