FORM 1023-EZ for BEAVER HOLLOW FARM ANIMAL RESCUE

Field Data
EIN 47-4274708
Case Number EO-2015169-000192
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BEAVER HOLLOW FARM ANIMAL RESCUE
Organization’s Mailing Address 9501 WOODPECKER ROAD
City CHESTERFIELD
State VA
ZIP 22838
Accounting period End 12
Primary contact name CHERYL BEAVERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHERYL BEAVERS
PRESIDENT
9501 WOODPECKER ROAD
CHESTERFIELD VA 23838

Officer/Director/Trustee Two

KIMBERLY CLEMENTS
SECRETARY
8549 BRECHIN LANE
CHESTERFIELD VA 23838

Officer/Director/Trustee Three

ROBIN AUSTIN
TREASURER
1103 CONDUIT ROAD
COLONIAL HEIGHTS VA 23834

Organization’s website
Organization’s email CHERYLBEAVERS1@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2015
Organization Incorporation State VA
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: No
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 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
Signature Title
Signature Date

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