FORM 1023-EZ for GREAT DIVIDE ANIMAL RESCUE INC

Field Data
EIN 82-1617674
Case Number EO-2017163-000307
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GREAT DIVIDE ANIMAL RESCUE INC
Organization’s Mailing Address PO BOX 5002
City BURLINGTON
State NC
ZIP 27216
Accounting period End 12
Primary contact name MELODY NICHOLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BARBARA PERRY
VICE PRESIDENT/DIRECTOR
PO BOX 5002
BURLINGTON NC 27216

Officer/Director/Trustee Two

MELODY NICHOLS
PRESIDENT/SECRETARY/DIRECTOR
PO BOX 5002
BURLINGTON NC 27216

Officer/Director/Trustee Three

PAUL LENNOX
TREASURER/DIRECTOR
PO BOX 5002
BURLINGTON NC 27216

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/2017
Organization Incorporation State NC
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
Signature Title
Signature Date

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