FORM 1023-EZ for CASWELL PET LIFELINE INC

Field Data
EIN 45-5359452
Case Number EO-2015268-000278
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CASWELL PET LIFELINE INC
Organization’s Mailing Address PO BOX 154
City YANCEYVILLE
State NC
ZIP 27379-0154
Accounting period End 12
Primary contact name WILLIAM BUSH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM BUSH
CHAIR
8040 PARK SPRINGS RD
RUFFIN NC 27326

Officer/Director/Trustee Two

MARY STEWART
SECRETARY
613 WOODLAND RD
RALEIGH NC 27603

Officer/Director/Trustee Three

PATRICIA BUSH
TREASURER
8040 PARK SPRINGS RD
RUFFIN NC 27326

Organization’s website CASWELLPETLIFELINE.ORG
Organization’s email ADOPT@CASWELLPETLIFELINE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/2012
Organization Incorporation State NC
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: 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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