FORM 1023-EZ for K-9 HERO HAVEN INC

Field Data
EIN 47-5227436
Case Number EO-2015327-000301
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name K-9 HERO HAVEN INC
Organization’s Mailing Address 176 MAHANDY CREEK LANE
City HERDON
State PA
ZIP 17830
Accounting period End 12
Primary contact name ANNE M GIBBS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANNE GIBBS
PRESIDENT
176 MAHANOY CREEK LANE
HERDON PA 17830

Officer/Director/Trustee Two

MICHAEL GIBBS
VICE PRESIDENT
176 MAHANOY CREEK LANE
HERDON PA 17830

Organization’s website
Organization’s email K9HEROHAVEN@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
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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