FORM 1023-EZ for BLUEGRASS PETS FOR LIFE INC

Field Data
EIN 84-3136642
Case Number EO-2020034-000066
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUEGRASS PETS FOR LIFE INC
Organization’s Mailing Address 801 WALKER LANE
City SPRINGFIELD
State KY
ZIP 40069
Accounting period End 12
Primary contact name ARIELLA GIBSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARIELLA GIBSON
FOUNDER/DIRECTOR
801 WALKER LANE
SPRINGFIELD KY 40069

Officer/Director/Trustee Two

JUDY PINKSTON
OFFICER
315
SPRINGFIELD KY 40069

Officer/Director/Trustee Three

SHAINA LENZ
OFFICER
1736 CANE RUN ROAD
SPRINGFIELD KY 40069

Organization’s website FACEBOOK.COM/BLUEGRASSPETSFORLIFE
Organization’s email BLUEGRASSPETSFORLIFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/16/2019
Organization Incorporation State KY
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 ARIELLA GIBSON
Signature Title FOUNDER/DIRECTOR
Signature Date 1/30/2020

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