FORM 1023-EZ for WCPLF PET RESCUE

Field Data
EIN 81-1873324
Case Number EO-2016166-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WCPLF PET RESCUE
Organization’s Mailing Address 207 ORIOLE DRIVE
City MCMINNVILLE
State TN
ZIP 37110
Accounting period End 12
Primary contact name NICOLE DERRIG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NICOLE DERRIG
FOUNDER/INCORPORATOR
207 ORIOLE DRIVE
MCMINNVILLE TN 37110

Officer/Director/Trustee Two

PAMELA COX
CO-FOUNDER/INCORPORATOR
209 ORIOLE DRIVE
MCMINNVILLE TN 37110

Officer/Director/Trustee Three

BRANDON HANSEN
INCORPORATOR
207 ORIOLE DRIVE
MCMINNVILLE TN 37110

Organization’s website WWW.FACEBOOK.COM/WCPLF
Organization’s email WCPLF@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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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