FORM 1023-EZ for WASHINGTON COUNTY ANIMAL ABUSE RELIEF FUND

Field Data
EIN 85-1803499
Case Number EO-2020295-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WASHINGTON COUNTY ANIMAL ABUSE RELIEF FUND
Organization’s Mailing Address 110 ROBINHOOD
City MCMURRAY
State PA
ZIP 15317
Accounting period End 12
Primary contact name FAITH BJALOBOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FAITH BJALOBOK
PRESIDENT
110 ROBINHOOD LANE
MCMURRAY PA 15317

Officer/Director/Trustee Two

NICK SHERMAN
VICE PRESIDENT
2073 MAJESTIC DRIVE
CANONSBURG PA 15317

Officer/Director/Trustee Three

TOM FLICKENGER
TREASURER
155 DODD DRIVE
WASHINGTON PA 15301

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 No
Correctness Declaration Yes
Signature Name FAITH BJALOBOK
Signature Title PRESIDENT
Signature Date 10/10/2020

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