FORM 1023-EZ for A GOOD LIFE ANIMAL SOCIETY

Field Data
EIN 82-5105013
Case Number EO-2018109-000358
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A GOOD LIFE ANIMAL SOCIETY
Organization’s Mailing Address 629 N 15TH ST
City MURPHYSBORO
State IL
ZIP 62966
Accounting period End 12
Primary contact name KRISTEN DUFFY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAMELA EATON
DIRECTOR, SECRETARY
861 DUMAROC RD
DESOTO IL 62924-3025

Officer/Director/Trustee Two

JASON HENRY
DIRECTOR, TREASURER
629 N 15TH ST
MURPHYSBORO IL 62966-1808

Officer/Director/Trustee Three

SUSANNAH LEBARON
DIRECTOR, PRESIDENT
629 N 15TH ST
MURPHYSBORO IL 62966-1808

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/17
Organization Incorporation State IL
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: Yes
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 Yes
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 SUSANNAH LEBARON
Signature Title PRESIDENT
Signature Date 4/16/18

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