FORM 1023-EZ for WORTHY DOG RESCUE INC

Field Data
EIN 82-1894394
Case Number EO-2017177-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WORTHY DOG RESCUE INC
Organization’s Mailing Address 11654 PLAZA AMERICA DR STE 294
City RESTON
State VA
ZIP 20190-4700
Accounting period End 6
Primary contact name PATRICK FOSTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUZANNE LAWTER
PRESIDENT AND DIRECTOR
2220 ARYNESS DR
VIENNA VA 22181-3045

Officer/Director/Trustee Two

JESSICA ILLICH
SECRETARY AND DIRECTOR
70 I ST SE APT 919
WASHINGTON DC 20003-4831

Officer/Director/Trustee Three

PATRICK FOSTER
TREASURER AND DIRECTOR
2220 ARYNESS DR
VIENNA VA 22181-3045

Officer/Director/Trustee Four

DANNEAN HETZEL
DIRECTOR
6721 QUANDER RD
ALEXANDRIA VA 22307-1651

Officer/Director/Trustee Five

ALICIA SCHWARTZ
DIRECTOR
1669 CUNNINGHAM DR
ROCK HILL SC 29732-7821

Organization’s website WORTHYDOG.ORG
Organization’s email INFO@WORTHYDOG.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/2017
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 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 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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