FORM 1023-EZ for A CANINE GEM RESCUE

Field Data
EIN 82-1220469
Case Number EO-2017110-000240
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name A CANINE GEM RESCUE
Organization’s Mailing Address 214 WOODRIDGE ROAD
City COLCHESTER
State VT
ZIP 05446
Accounting period End 12
Primary contact name HILARY DAVIS COATES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HILARY DAVIS COATES
PRESIDENT AND TREASURER
214 WOODRIDGE ROAD
COLCHESTER VT 05446

Officer/Director/Trustee Two

STACEY DAVIS SIEGEL
VICE PRESIDENT
24 VANAD DRIVE
ROSLYN NY 11576

Officer/Director/Trustee Three

KIM GRAHAM
SECRETARY
53JOCELYN CT
COLCHESTER VT 05446

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2017
Organization Incorporation State VT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
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 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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