FORM 1023-EZ for SHADOWS VETERINARIAN RELIEF TRUST

Field Data
EIN 84-6552236
Case Number EO-2019238-000248
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHADOWS VETERINARIAN RELIEF TRUST
Organization’s Mailing Address 14 KING HIGHWAY NORTH
City RANDOLPH
State NY
ZIP 14772
Accounting period End 12
Primary contact name ELLEN G SPENCER ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIMOTHY STANLEY
TRUSTEE
14 KING HIGHWAY NORTH
RANDOLPH NY 14772

Officer/Director/Trustee Two

JEREMY BECK
TRUSTEE
65 STONERIDGE LANE
ELMA NY 14059

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D40 - Veterinary Services
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TIMOTHY STANLEY
Signature Title TRUSTEE
Signature Date 8/22/19

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