FORM 1023-EZ for C BAR J HORSEHAVEN RESCUE INC

Field Data
EIN 27-1003330
Case Number EO-2016109-000309
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name C BAR J HORSEHAVEN RESCUE INC
Organization’s Mailing Address 18032 SILVER LODE DRIVE
City DOLAN SPRINGS
State AZ
ZIP 86441
Accounting period End 12
Primary contact name KATHERINE BIBBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CYNTHIA JACKSON
PRESIDENT AND DIRECTOR
18032 SILVER LODE DRIVE
DOLAN SPRINGS AZ 86441

Officer/Director/Trustee Two

DEBORAH BIBBY
TREASURER AND DIRECTOR
16021 PIERCE FERRY ROAD PMB 18
DOLAN SPRINGS NV 86441

Officer/Director/Trustee Three

KATHERINE BIBBY
SECRETARY AND DIRECTOR
5179 CARTARO DRIVE
LAS VEGAS NV 89103

Organization’s website WWW.CBARJHORSEHAVENRESCUE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/2011
Organization Incorporation State AZ
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: 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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