FORM 1023-EZ for CANINE LICENSE REGISTRY INC

Field Data
EIN 47-4146317
Case Number EO-2015161-000427
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CANINE LICENSE REGISTRY INC
Organization’s Mailing Address 20 SOUTH ST
City EDMESTON
State NY
ZIP 13335
Accounting period End 12
Primary contact name JOEL STAPLES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOEL STAPLES
OFFICER
20 SOUTH ST
EDMESTON NY 13335

Officer/Director/Trustee Two

DAVID BLACKMAN
DIRECTOR
30 NORTH ST
EDMESTON NY 13335

Officer/Director/Trustee Three

REBECCA BATES
DIRECTOR
921 STATE HIGHWAY 8
WEST EDMESTON NY 13845

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/27/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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