FORM 1023-EZ for LUKES LEGACY SPAY AND NEUTER

Field Data
EIN 47-5363650
Case Number EO-2016354-000267
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LUKES LEGACY SPAY AND NEUTER
Organization’s Mailing Address PO BOX 404
City KAPOWSIN
State WA
ZIP 98344
Accounting period End 12
Primary contact name HEATHER BURLESON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VICKI HERRICK
PRESIDENT, DIRECTOR
1048 SPORTMAN LN SE
OLYMPIA WA 98513

Officer/Director/Trustee Two

CINDY GRENIER
SECRETARY, DIRECTOR
PO BOX 811
COSMOPOLIS WA 98537

Officer/Director/Trustee Three

CORA WELLS
TREASURER, DIRECTOR
6515 HOMESTEAD AVE
TACOMA WA 98404

Officer/Director/Trustee Four

KATE VON DE COVERING
DIRECTOR
17426 MIMA ACRES DR
TENINO WA 98589

Officer/Director/Trustee Five

HEATHER BURLESON
EXECUTIVE DIRECTOR
PO BOX 404
KAPOWSIN WA 98344

Organization’s website WWW.LUKESLEGACYSPAYANDNEUTER.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2015
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
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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