FORM 1023-EZ for SHAYS VISION INC

Field Data
EIN 47-1680656
Case Number EO-2014314-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHAYS VISION INC
Organization’s Mailing Address 888 W VUELTA GRANADINA
City SAHUARITA
State AZ
ZIP 85629
Accounting period End 12
Primary contact name ERIKA LOPEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIKA LOPEZ
DIRECTOR
888 W VUELTA GRANADINA
SAHUARITA AZ 85629

Officer/Director/Trustee Two

MAX ANDREW BAUMANN
DIRECTOR
3287 N NAMBE DRIVE
TUCSON AZ 85749

Officer/Director/Trustee Three

DAVID L SWANSON
DIRECTOR
7712 S FRESHWATER PEARL DRIVE
TUCSON AZ 85747

Officer/Director/Trustee Four

STEVE WETMORE
DIRECTOR
5008 N VALLEY SHADOWS PLACE
TUCSON AZ 85750

Officer/Director/Trustee Five

KASEY C HOPPER
DIRECTOR
7802 E ELIDA
TUCSON AZ 85715

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/18/2014
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
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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