FORM 1023-EZ for FAT HEADS RESCUE INC

Field Data
EIN 47-2239394
Case Number EO-2014349-000343
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAT HEADS RESCUE INC
Organization’s Mailing Address 132 E MAPLE CT
City CLARKSVILLE
State IN
ZIP 47129
Accounting period End 12
Primary contact name DAVIDA MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVIDA MILLER
PRESIDENT
132 E MAPLE CT
CLARKSVILLE IN 47129

Officer/Director/Trustee Two

MORGAN DAVIS
VICE PRESIDENT
12313 GRANTLINE RD
NEW ALBANY IN 47150

Officer/Director/Trustee Three

TIMOTHY LECLAIR
SECRETARY
12313 GRANTLINE RD
NEW ALBANY IN 47150

Officer/Director/Trustee Four

PAIGE GEDLING
TREASURER
11722 PERRY CROSSING PKWY
SELLERSBURG IN 47172

Officer/Director/Trustee Five

JAMES PADGETT
CHAIR PERSON
132 E MAPLE CT
CLARKSVILLE IN 47129

Organization’s website WWW.FATHEADSRESCUE.ORG
Organization’s email DAVIDA@FATHEADSRESCUE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/2014
Organization Incorporation State IN
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 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
Signature Title
Signature Date

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