FORM 1023-EZ for FORGOTTEN COAST K9 INC

Field Data
EIN 86-3718806
Case Number EO-2021158-000388
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORGOTTEN COAST K9 INC
Organization’s Mailing Address 249 NW ROLLING HILLS DR
City MADISON
State FL
ZIP 32340
Accounting period End 12
Primary contact name JOHN OBRIAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN OBRIAN
PRESIDENT DIRECTOR
249 NW ROLLING HILLS DR
MADISON FL 32340

Officer/Director/Trustee Two

JULIE MADISON
SECRETARY DIRECTOR
249 NW ROLLING HILLS DR
MADISON FL 32340

Officer/Director/Trustee Three

PATRICK WHITE
TREASURER DIRECTOR
249 NW ROLLING HILLS DR
MADISON FL 32340

Officer/Director/Trustee Four

DAVID EASTABROOKS JR
DIRECTOR
249 NW ROLLING HILLS DR
MADISON FL 32340

Officer/Director/Trustee Five

CAROLYN CABOT
DIRECTOR
249 NW ROLLING HILLS DR
MADISON FL 32340

Organization’s website WWW.FORGOTTENCOASTK9.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/7/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOHN OBRIAN
Signature Title PRESIDENT DIRECTOR
Signature Date 6/4/2021

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