FORM 1023-EZ for K9PHOTO

Field Data
EIN 84-4078002
Case Number EO-2020034-000266
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name K9PHOTO
Organization’s Mailing Address 608 RED OAK PLANTATION
City KINGSPORT
State TN
ZIP 37663-2559
Accounting period End 12
Primary contact name MICHAEL PUCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL PUCK
PRESIDENT
608 RED OAK PLANTATION
KINGSPORT TN 37663-2559

Officer/Director/Trustee Two

ADA FLAHERTY
DIRECTOR
PO BOX 1982
BRISTOL TN 37621-1982

Officer/Director/Trustee Three

KRISTIN BENSON
DIRECTOR
1201 RIDGECREST RD
JOHNSON CITY TN 37604

Officer/Director/Trustee Four

SARAH BRAZEE
SECRETARY
1449 WARPATH DRIVE
KINGSPORT TN 37664

Officer/Director/Trustee Five

BRETT RUBIN
DIRECTOR
275 SPALDING SPRINGS LANE
SANDY SPRINGS GA 30350

Organization’s website WWW.K9PHOTO.ORG
Organization’s email K9PHOTOTN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/28/2019
Organization Incorporation State TN
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHAEL PUCK
Signature Title PRESIDENT
Signature Date 1/30/2020

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