FORM 1023-EZ for K9 VETERANS MEMORIAL FOUNDATION INC

Field Data
EIN 47-1972546
Case Number EO-2018060-000144
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name K9 VETERANS MEMORIAL FOUNDATION INC
Organization’s Mailing Address 1241 NW 50TH AVE
City GAINESVILLE
State FL
ZIP 32609-718
Accounting period End 12
Primary contact name BERNICE CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BERNICE CAMPBELL
DIRECTOR
1241 NW 50TH AVE SUITE B
GAINESVILLE FL 32609-718

Organization’s website WWW.K9VETERANSMEMORIAL.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/14
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BERNICE CAMPBELL
Signature Title DIRECTOR
Signature Date 2/27/18
EIN 47-1972546
Case Number EO-2015114-000193
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name K9 VETERANS MEMORIAL FOUNDATION INC
Organization’s Mailing Address 2702 NW 49TH PLACE
City GAINESVILLE
State FL
ZIP 32605-1212
Accounting period End 12
Primary contact name BERNICE CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BERNICE CAMPBELL
DIRECTOR
2702 NW 49TH PLACE
GAINESVILLE FL 32605-1212

Officer/Director/Trustee Two

JAMES LYNCH
ASSISTANT DIRECTOR
3415 NW 46TH PLACE
GAINESVILLE FL 32605-1804

Officer/Director/Trustee Three

RICHARD VAN DEN BOSCH
ASSISTANT DIRECTOR
17118 NW 138TH AVENUE
ALACHUA FL 32615-5201

Officer/Director/Trustee Five




Gainesville FL

Organization’s website
Organization’s email K9VETERANSMEMORIAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 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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