FORM 1023-EZ for ARIZONA NURSE PRACTITIONER FOUNDATION

Field Data
EIN 82-2104347
Case Number EO-2019037-000685
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ARIZONA NURSE PRACTITIONER FOUNDATION
Organization’s Mailing Address 5425 EAST FLOWER STREET
City SCOTTSDALE
State AZ
ZIP 85018
Accounting period End 12
Primary contact name DALE ANN DORSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DALE DORSEY
PRESIDENT
5425 EAST FLOWER STREET
PHOENIX AZ 85018

Officer/Director/Trustee Two

SHELLEY VAUGHN
DIRECTOR
363 W 160 S
PIMA AZ 85543

Officer/Director/Trustee Three

SUN JONES
DIRECTOR
2723 S LARKSPUR ST
GILBERT AZ 85295

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/17
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 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 DALE DORSEY
Signature Title PRESIDENT
Signature Date 1/27/19

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