FORM 1023-EZ for CAUCASIAN OVCHARKA RESCUE & REHOME

Field Data
EIN 83-3375835
Case Number EO-2019038-000509
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAUCASIAN OVCHARKA RESCUE & REHOME
Organization’s Mailing Address 10 SEDGWICK STREET
City PITTSBURGH
State PA
ZIP 15209
Accounting period End 12
Primary contact name JACQUELYNN MICHALIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELYNN MICHALIK
OFFICER
10 SEDGWICK STREET
PITTSBURGH PA 15209

Organization’s website HTTPS://WWW.FACEBOOK.COM/CAUCASIANOVCHARKARESCUEUSA/
Organization’s email CSDOGS4AKC@AOL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/24/15
Organization Incorporation State PA
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JACQUELYNN MICHALIK
Signature Title OFFICER
Signature Date 1/31/19

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