FORM 1023-EZ for FOREVER ASSISTED LIVING FOR SENIORSMALL DOGS SANCTUARY INC

Field Data
EIN 82-5268457
Case Number EO-2018334-000153
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOREVER ASSISTED LIVING FOR SENIORSMALL DOGS SANCTUARY INC
Organization’s Mailing Address 17241 IRIS AVE
City RIVERSIDE
State CA
ZIP 92504
Accounting period End 12
Primary contact name DIANNA GOULD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANNA GOULD
PRESIDENT
17241 IRIS AVE
RIVERSIDE CA 92504

Officer/Director/Trustee Two

VICKIE HOY
TREASURER
17241 IRIS AVE
RIVERSIDE CA 92504

Officer/Director/Trustee Three

DEBORAH BUCHANAN
SECRETARY
17241 IRIS AVE
RIVERSIDE CA 92504

Organization’s website
Organization’s email DIANNAFAMILY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/18
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: 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 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 DIANNA GOULD
Signature Title PRESIDENT
Signature Date 11/28/18
EIN 82-5268457
Case Number EO-2018334-000153
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOREVER ASSISTED LIVING FOR SENIOR SMALL DOGS SANCTUARY INC
Organization’s Mailing Address 17241 IRIS AVE
City RIVERSIDE
State CA
ZIP 92504
Accounting period End 12
Primary contact name DIANNA GOULD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANNA GOULD
PRESIDENT
17241 IRIS AVE
RIVERSIDE CA 92504

Officer/Director/Trustee Two

VICKIE HOY
TREASURER
17241 IRIS AVE
RIVERSIDE CA 92504

Officer/Director/Trustee Three

DEBORAH BUCHANAN
SECRETARY
17241 IRIS AVE
RIVERSIDE CA 92504

Organization’s website
Organization’s email DIANNAFAMILY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/18
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: 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 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 DIANNA GOULD
Signature Title PRESIDENT
Signature Date 11/28/18

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