FORM 1023-EZ for SECOND CHANCE ANIMAL RESCUE

Field Data
EIN 38-4018518
Case Number EO-2016364-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SECOND CHANCE ANIMAL RESCUE
Organization’s Mailing Address 1278 GENESEE AVE
City MAYFIELD HEIGHTS
State OH
ZIP 44124
Accounting period End 12
Primary contact name KERRY AUGUSTINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KERRY AUGUSTINE
PRESIDENT
1278 GENESEE AVE
MAYFIELD HEIGHTS OH 44124

Officer/Director/Trustee Two

GREGORY DELISIO
VICE PRESIDENT
1278 GENESEE AVE
MAYFIELD HEIGHTS OH 44124

Officer/Director/Trustee Three

CHRISTINA AUGUSTINE
TREASURER
227 N DEPEYSTER ST
KENT OH 44240

Officer/Director/Trustee Four

BETHANY JONES
SECRETARY
7061 ASHLAWN DRIVE
BRECKSVILLE OH 44141

Organization’s website SCAROHIO.ORG
Organization’s email SCAROHIO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2016
Organization Incorporation State OH
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 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
Signature Title
Signature Date

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