FORM 1023-EZ for PIEDMONT ANIMAL WELFARE ALLIANCE

Field Data
EIN 82-2562731
Case Number EO-2017240-000239
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PIEDMONT ANIMAL WELFARE ALLIANCE
Organization’s Mailing Address 2521 PARKWAY DRIVE
City WINSTON-SALEM
State NC
ZIP 27103-3522
Accounting period End 12
Primary contact name LAWRENCE J SCOTT - AUTHORIZED REP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CANDIDE JONES
PRESIDENT, DIRECTOR
2521 PARKWAY DRIVE
WINSTON-SALEM NC 27103-3522

Officer/Director/Trustee Two

LORETTA ELLIOT
VP, SEC AND ASST TREASURER
2521 PARKWAY DRIVE
WINSTON-SALEM NC 27103-3522

Officer/Director/Trustee Three

LOUISE MOWBRAY
VP, ASST SEC AND TREASURER
2521 PARKWAY DRIVE
WINSTON-SALEM NC 27103-3522

Organization’s website
Organization’s email CANDIDEJONES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D61 - Animal Training, Behavior
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
Signature Title
Signature Date

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