FORM 1023-EZ for VETERINARY PRACTICE TRANSITION A NJNONPROFIT CORPORATION

Field Data
EIN 84-2000410
Case Number EO-2019161-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VETERINARY PRACTICE TRANSITION A NJNONPROFIT CORPORATION
Organization’s Mailing Address 206 HARTFORD ROAD
City MOUNT LAUREL
State NJ
ZIP 8054
Accounting period End 12
Primary contact name DEANA RACHUBA-SHULTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEANA RACHUBA-SHULTZ
TRUSTEE
110 MARTER AVE SUITE 210
MOORESTOWN NJ 8057

Officer/Director/Trustee Two

MARK HELFAT
PRESIDENT
206 HARTFORD ROAD
MOUNT LAUREL NJ 8054

Officer/Director/Trustee Three

GARY MAZZUCCO
TRUSTEE
110 MARTER AVE SUITE 210
MOORESTOWN NJ 8057

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/19
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 MARK HELFAT
Signature Title PRESIDENT
Signature Date 6/6/19

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