FORM 1023-EZ for NORTHERN ARIZONA WORKING DOG INC

Field Data
EIN 82-1964454
Case Number EO-2018270-000553
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTHERN ARIZONA WORKING DOG INC
Organization’s Mailing Address 874 N INDUSTRIAL DRIVE
City CAMP VERDE
State AZ
ZIP 86322
Accounting period End 12
Primary contact name SHAWN TUCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARRET LAMBETH
PRESIDENT
874 N INDUSTRIAL DRIVE
CAMP VERDE AZ 86322

Officer/Director/Trustee Two

MARCUS TUCKER
VICE PRESIDENT
874 N INDUSTRIAL DRIVE
CAMP VERDE AZ 86322

Officer/Director/Trustee Three

CORAL KARSTEN
SECRETARY
874 N INDUSTRIAL DRIVE
CAMP VERDE AZ 86322

Officer/Director/Trustee Four

JED LONGHURST
TREASURER
874 N INDUSTRIAL DRIVE
CAMP VERDE AZ 86322

Officer/Director/Trustee Five

SHAWN TUCKER
DIRECTOR
874 N INDUSTRIAL DRIVE
CAMP VERDE AZ 86322

Organization’s website
Organization’s email STUCKER@NOTHERNAZSERVICEDOGS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/17
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 GARRET LAMBETH
Signature Title PRESIDENT
Signature Date 9/25/18

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