FORM 1023-EZ for RESCUE REHAB REHOME

Field Data
EIN 82-2330196
Case Number EO-2017234-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RESCUE REHAB REHOME
Organization’s Mailing Address 12656 181ST ROAD
City LIVE OAK
State FL
ZIP 32060
Accounting period End 7
Primary contact name MARY MOORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY MOORE
PRESIDENT
12656 181ST ROAD
LIVE OAK FL 32060

Officer/Director/Trustee Two

EDWIN MOORE
MEDICAL ADVISOR
12656 181ST RD
LIVE OAK FL 32060

Officer/Director/Trustee Three

HAILEIGH MILLER
SECTY
12656 181ST RD
LIVE OAK FL 32060

Officer/Director/Trustee Four

WENDI TULLIS
VICE PRESIDENT
12090 N COUNTY ROAD 250
WELLBORN FL 32094

Officer/Director/Trustee Five

RACHEL TULLIS
TRAINER
12090 COUNTY RD 250
WELLBORN FL 32094

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2017
Organization Incorporation State FL
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: No
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 Yes
One Third Support Gifts No
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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