FORM 1023-EZ for BIBB COUNTY PET WELFARE

Field Data
EIN 81-4945560
Case Number EO-2017013-000479
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BIBB COUNTY PET WELFARE
Organization’s Mailing Address 134 SHIRLEY ROAD
City WOODSTOCK
State AL
ZIP 35188
Accounting period End 12
Primary contact name CHRISTINA SKROBAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINA SKROBAK
DIRECTOR
134 SHIRLEY RD
WOODSTOCK AL 35188

Officer/Director/Trustee Two

JUDITH PAYNE
DIRECTOR
54 PERRY LANE
WEST BLOCTON AL 35184

Officer/Director/Trustee Three

CAROL LUCAS
DIRECTOR
2897 BULLDOG BEND ROAD
BRIERFIELD AL 35035

Organization’s website
Organization’s email BIBBCOUNTYPETWELFARE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/2017
Organization Incorporation State AL
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: 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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