FORM 1023-EZ for SMITH COUNTY ANIMAL RESCUE ORGANIZATION

Field Data
EIN 83-2835304
Case Number EO-2019028-000365
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SMITH COUNTY ANIMAL RESCUE ORGANIZATION
Organization’s Mailing Address 53 FRIENDSHIP HOLLOW RD N
City PLEASANT SHADE
State TN
ZIP 37145
Accounting period End 12
Primary contact name SHERRY HAYES-LUZADER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERRY HAYES-LUZADER
PRESIDENT
53 FRIENDSHIP HOLLOW RD N
PLEASANT SHADE TN 37145

Officer/Director/Trustee Two

SUSIE DENNIS
VICE PRESIDENT
46 FRIENDSHIP HOLLOW RD S
PLEASANT SHADE TN 37145

Officer/Director/Trustee Three

FAYE JONES
SECRETARY
413 GRANT HWY
GORDONSVILLE TN 38563

Officer/Director/Trustee Four

KRISTIN UHLER SMITH
TREASURER
275 HARRIS HOLLOW RD
PLEASANT SHADE TN 37145

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/9/18
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: 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 Yes
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 SHERRY HAYES-LUZADER
Signature Title PRESIDENT
Signature Date 12/14/18

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