FORM 1023-EZ for STREET SAVVY DOG RESCUE

Field Data
EIN 81-1291495
Case Number EO-2016349-000388
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STREET SAVVY DOG RESCUE
Organization’s Mailing Address 9116 SE CLAY STREET
City PORTLAND
State OR
ZIP 97216-1845
Accounting period End 12
Primary contact name JACLYN LEEDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BARBETTE FALK
PRESIDENT
9116 SE CLAY STREET
PORTLAND OR 97216-1845

Officer/Director/Trustee Two

AMANDA KANTER
SECRETARY
2203 SE ASH STREET
PORTLAND OR 97214-1631

Officer/Director/Trustee Three

SCHELENE KROCKA
TREASURER
10820 NE 68TH CIRCLE
VANCOUVER WA 98662-4813

Officer/Director/Trustee Four

CHRISTA LADEN
BOARD MEMBER
6242 SE MCNARY ROAD
MILWAUKIE OR 97266-5117

Officer/Director/Trustee Five

PATTY FREEMAN
BOARD MEMBER
4015 SE SCHILLER STREET
PORTLAND OR 97202-4065

Organization’s website HTTP://WWW.STREETSAVVYDOGRESCUE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/2015
Organization Incorporation State OR
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: 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 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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