FORM 1023-EZ for JUSTICE FOR SAMSON ANIMAL RESCUE

Field Data
EIN 83-0941940
Case Number EO-2019029-000205
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JUSTICE FOR SAMSON ANIMAL RESCUE
Organization’s Mailing Address 141 CR 480
City PANDORA
State TX
ZIP 78143
Accounting period End 6
Primary contact name LORELEI BRANDON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORELEI BRANDON
FOUNDER
141 CR 480
PANDORA TX 78143

Officer/Director/Trustee Two

MELINDA BASS
SECRETARY
217 W ROBIN LN APT A
HARKER HEIGHTS TX 76548

Officer/Director/Trustee Three

DEANA MULDER
MARKETING
5470 HOLLAND DR
ARVADA CO 80002

Organization’s website HTTP://JUSTICEFORSAMSONPAWS.RESCUEGROUPS.ORG
Organization’s email JUSTICEFORSAMSON@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/18
Organization Incorporation State TX
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 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 LORELEI BRANDON
Signature Title FOUNDER
Signature Date 12/16/18

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