FORM 1023-EZ for DOUBLE ARROW RANCH & RESCUE

Field Data
EIN 83-0706634
Case Number EO-2018239-000461
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOUBLE ARROW RANCH & RESCUE
Organization’s Mailing Address 15320 CHISUM TRAIL
City PENN VALLEY
State CA
ZIP 95946
Accounting period End 12
Primary contact name SHARON BLUME
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON BLUME
CHIEF OPERATING OFFICER
15320 CHISUM TRAIL
PENN VALLEY CA 95946

Officer/Director/Trustee Two

JERRY LUCAS
CHIEF FINANCIAL OFFICER
15320 CHISUM TRAIL
PENN VALLEY CA 95946

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/18
Organization Incorporation State CA
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 No
Correctness Declaration Yes
Signature Name SHARON BLUME
Signature Title CHIEF OPERATING OFFICER
Signature Date 8/23/18

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