FORM 1023-EZ for COUNTRY HEART FARM

Field Data
EIN 81-4215209
Case Number EO-2017082-000337
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COUNTRY HEART FARM
Organization’s Mailing Address 311 HANNAH ST
City SUGARLOAF
State PA
ZIP 18249
Accounting period End 12
Primary contact name PATRICIA RODRIGUEZ-HUDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA RODRIGUEZ-HUDSON
PRESIDENT
311 HANNAH ST
SUGARLOAF PA 18249

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2016
Organization Incorporation State PA
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 No
One Third Support Gifts Yes
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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