FORM 1023-EZ for SERENDIPITY SPRINGS SANCTUARY

Field Data
EIN 83-2258014
Case Number EO-2019186-000220
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SERENDIPITY SPRINGS SANCTUARY
Organization’s Mailing Address PO BOX 418
City DOBBINS
State CA
ZIP 95935
Accounting period End 12
Primary contact name SUZANNE LARSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUZANNE LARSEN
PRESIDENT
PO BOX 418
DOBBINS CA 95935

Officer/Director/Trustee Two

MICHELE KILMER
VICE PRESIDENT
405 BELLEVUE AVE APT 101
OAKLAND CA 94610

Officer/Director/Trustee Three

LISA BAKER
SCTY/TREAS
14444 MERRIAM RD SP1
DOBBINS CA 95935

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/19
Organization Incorporation State CA
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: Yes
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 Yes
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 SUZANNE LARSEN
Signature Title PRESIDENT
Signature Date 7/2/19

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