FORM 1023-EZ for K9 THERAPEUTIC HEALING LTD

Field Data
EIN 81-2803454
Case Number EO-2016155-000289
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name K9 THERAPEUTIC HEALING LTD
Organization’s Mailing Address 7930 WEST LAKEVIEW COURT
City PALOS HEIGHTS
State IL
ZIP 60463-2522
Accounting period End 12
Primary contact name MARK PELECH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARK PELECH
DIRECTOR
7930 LAKEVIEW COURT
PALOS HEIGHTS IL 60463-2522

Officer/Director/Trustee Two

NANCY MCCOY MIDLOCK
DIRECTOR
24664 WEST PARK RIVER LANE
SHOREWOOD IL 60404

Officer/Director/Trustee Three

ANDREW MIDLOCK
DIRECTOR
24664 WEST PARK RIVER LANE
SHOREWOOD IL 60404

Officer/Director/Trustee Four

CAROLE DILL
DIRECTOR
6105 W 55TH
CHICAGO IL 60638

Officer/Director/Trustee Five

NANCY MULVILHILL
DIRECTOR
6738 TINLEY PARK DRIVE
TINLEY PARK IL 60477

Organization’s website K9TH.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 No
One Third Support Gifts Yes
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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