FORM 1023-EZ for DESERT HAVEN ANIMAL SOCIETY INC

Field Data
EIN 81-0707433
Case Number EO-2016012-000805
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DESERT HAVEN ANIMAL SOCIETY INC
Organization’s Mailing Address 1440 W CARROL STREET
City PAHRUMP
State NV
ZIP 89060
Accounting period End 12
Primary contact name SUZANNE ZERVANTIAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUZANNE ZERVANTIAN
PRESIDENT
1440 W CARROL STREET
PAHRUMP NV 89060

Officer/Director/Trustee Two

LEONE JONES
VICE-PRESIDENT
3891 S TAHACHAPI AVENUE
PAHRUMP NV 89048

Officer/Director/Trustee Three

PATRICIA GOLDSTEIN
TREASURER
2641 YUCCA TERRACE AVENUE
PAHRUMP NV 89048

Officer/Director/Trustee Four

JEAN SMILEY JOHNSON
SECRETARY
1931 BLACKHORN STREET
PAHRUMP NV 89048

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/2015
Organization Incorporation State NV
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: 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 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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