Date of incorporation

State of incorporation

In which country is the organization incorporated?

Does the organization have tax-exempt (501(c)(3) or (c)(4)) status?

How is or will the organization be classified?

501(c)(3) public charity501(c)(3) private foundation (includes operating foundation)501(c)(4)Other

Effective date of tax exemption

How long has the organization been operating?

Less than 3 yearsMore than 3 years

Please attach a business plan, including the following:

a) Who are you serving, and is your scope limited to a specific geographic area?
b) Fundraising plans and expected sources of financial support for the next 3 years
c) Scope of impact if mission achieved – Paint a picture of what you see as success
d) Proposed budget for the next 3 years
e) List of proposed or current directors

What are the organization's sources of funding?

What is the organization’s budget for its most recently completed year?

Please attach the following documents in single .pdf format:

- The organization's most recent 990

- 1023 or 1024-A application (if applicable)

- Determination Letter (if applicable)

- Certificate of Incorporation

- Bylaws

Please list the organization's directors and officers.

Does the organization have any full or part-time employees?

YesNo

How many full-time employees?

Mission statement

Please describe the programs the organization operates or plans to operate.

Does the organization house or arrange for housing for animals?

YesNo

Where are the animals housed?

Property owned by the nonprofitProperty leased from others (including founder, board members, others)FostersOther

Is there a written lease?

YesNo

Project description: Please provide a description of the project with which you are requesting help. Provide as much detail as possible without sharing confidential information (e.g., employee names).

What kind of legal guidance are you seeking?

What kind of work does your organization do or plan to do? Check all that apply.

Please explain.

Are you currently planning to take action on any of the following in the next 3 months?

Form a new nonprofit or other entityApply for tax-exempt statusLaunch a new advocacy or lobbying campaignSeparate from a fiscal sponsorNone of the above/just exploring