FORM 1023-EZ for JACKSON COUNTY SPCA

Field Data
EIN 20-1490013
Case Number EO-2016229-000036
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JACKSON COUNTY SPCA
Organization’s Mailing Address 9822 AL HWY 71
City PISGAH
State AL
ZIP 35765
Accounting period End 12
Primary contact name LAURIE SHAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURIE SHAW
DIRECTOR
9822 AL HWY 71
PISGAH AL 35765

Officer/Director/Trustee Two

LOUISE ROSEBERRY
SECRETARY
105 MAPLE ST
PISGAH AL 35765

Officer/Director/Trustee Three

BRIAN STEINMETA
BOARD MEMBER
9822 AL HWY 71
PISGAH AL 35765

Officer/Director/Trustee Four

SHARON BARTLETT
BOARD MEMBER
307 DOLPHIN POINT DR
LANGSTON AL 35756

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/2004
Organization Incorporation State AL
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: 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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