FORM 1023-EZ for PETS IN NEED IN SOUTHERN MARYLAND INC

Field Data
EIN 81-3587071
Case Number EO-2016291-000330
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PETS IN NEED IN SOUTHERN MARYLAND INC
Organization’s Mailing Address 38873 HIDDEN POND COURT
City MECHANICSVILLE
State MD
ZIP 20659
Accounting period End 12
Primary contact name KIMBERLY HOLT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY HOLT
PRESIDENT
38873 HIDDEN POND COURT
MECHANICSVILLE MD 20659

Officer/Director/Trustee Two

DARIN HOLT
VICE-PRESIDENT
38873 HIDDEN POND COURT
MECHANICSVILLE MD 20659

Officer/Director/Trustee Three

ASHLEIGH HOLT
TREASURER
1000 BALCONES DRIVE APT 13
COLLEGE STATION TX 77845

Officer/Director/Trustee Four

MEGAN RUSSELL
SECRETARY
22260 ZACKS WAY
LEONARDTOWN MD 20650

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2016
Organization Incorporation State MD
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 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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