FORM 1023-EZ for THE CHICKEN REFUGE

Field Data
EIN 81-4557117
Case Number EO-2017010-000289
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE CHICKEN REFUGE
Organization’s Mailing Address PO BOX 1201
City WHITEHOUSE STATION
State NJ
ZIP 08889
Accounting period End 12
Primary contact name KATHY BALLANCE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHY BALLANCE
PRESIDENT
7 42ND STREET
WHITEHOUSE STATION NJ 08889

Officer/Director/Trustee Two

ERIN FULTON
VICE PRESIDENT
307 S BRANCH DRIVE
WHITEHOUSE STATION NJ 08889

Officer/Director/Trustee Three

ANNA WALZ
VICE PRESIDENT
673 FOX FARM ROAD
ASBURY NJ 08802

Organization’s website HTTP://WWW.THECHICKENREFUGE.ORG/
Organization’s email INFO@THECHICKENREFUGE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/19/2016
Organization Incorporation State NJ
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 Yes
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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