FORM 1023-EZ for SHORE WILDLIFE REHAB

Field Data
EIN 46-2116812
Case Number EO-2015189-000046
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHORE WILDLIFE REHAB
Organization’s Mailing Address 7027 MACKATOUCES POINT RD
City JAMESVILLE
State VA
ZIP 23398
Accounting period End 12
Primary contact name GAY FRAZEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GAY FRAZEE
PRESIDENT/TREASURER
7027 MACKATOUCES POINT RD
JAMESVILLE VA 23398

Officer/Director/Trustee Two

KATHALEEN CUMMINGS
VICE PRESIDENT/SECRETARY
16091 PUNGOTEAGUE RD
PAINTER VA 23420

Officer/Director/Trustee Three

PAULA CAMERON
DIRECTOR
34424 LANKFORD HWY
PAINTER VA 23420

Organization’s website
Organization’s email YAG113@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2013
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D30 - Wildlife Preservation, Protection
Organization’s purpose Charitable: Yes
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 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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