FORM 1023-EZ for NATIONAL LACY DOG REGISTRY

Field Data
EIN 47-3967149
Case Number EO-2015251-000415
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NATIONAL LACY DOG REGISTRY
Organization’s Mailing Address 1018 OVERLOOK
City GRANITE SHOALS
State TX
ZIP 78654
Accounting period End 12
Primary contact name COURTNEY FARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROD BUVENS
PRESIDENT
PO BOX 206
MARBLE FALLS TX 78654

Officer/Director/Trustee Two

COURTNEY FARRIS
SECRETARY
PO BOX 1634
KINGSLAND TX 78639

Officer/Director/Trustee Three

KAREN LEWIS
VICE PRESIDENT
667 PHILLIPS RD
SAINT JOSEPH LA 71366

Organization’s website WWW.LACYDOGREGISTRY.COM
Organization’s email LACYDOGREGISTRY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
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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