FORM 1023-EZ for FRIENDS OF THE HORN LAKE ANIMAL SHELTER

Field Data
EIN 84-3053174
Case Number EO-2019262-000130
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRIENDS OF THE HORN LAKE ANIMAL SHELTER
Organization’s Mailing Address 3585 HEATHCLIFF DR
City HORN LAKE
State MS
ZIP 38637
Accounting period End 12
Primary contact name LISA HAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA HAYES
PRESIDENT
3585
HORN LAKE MS 38637-2512

Officer/Director/Trustee Two

STEPHANIE MOTHERSHED
VICE PRESIDENT
7417 JENNIFER
HORN LAKE MS 38637

Officer/Director/Trustee Three

FAYE EGNER
TREASURE
JENNIFER
HORN LAKE MS 38637

Officer/Director/Trustee Four

KELLY SMITH
SECRETARY
3780 WARRINGTON
HORN LAKE MS 38637

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/19
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D11 - Single Organization Support
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 LISA HAYES
Signature Title PRESIDENT
Signature Date 9/17/19

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