FORM 1023-EZ for RUFF LIFE RESCUE

Field Data
EIN 82-2862544
Case Number EO-2017285-000126
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RUFF LIFE RESCUE
Organization’s Mailing Address 29795 SALMON RIVER HWY
City GRAND RONDE
State OR
ZIP 97347
Accounting period End 9
Primary contact name ANGIE PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGIE PETERSON
EXECUTIVE DIRECTOR
29795 SALMON RIVER HWY
GRAND RONDE OR 97347

Officer/Director/Trustee Two

DENNIS CHURCH
BOARD MEMBER
422 NW REED LN
DALLAS OR 97338

Officer/Director/Trustee Three

JANELL IVERSON
BOARD MEMBER
4527 SUNLAND ST SE
SALEM OR 97302

Officer/Director/Trustee Four

RICHARD FRAISEUR
BOARD MEMBER
34800 SPICER SCHOOL RD
LEBANON OR 97355

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/21/2017
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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