FORM 1023-EZ for THE VILLAGE AZ

Field Data
EIN 83-0563070
Case Number EO-2018171-000607
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE VILLAGE AZ
Organization’s Mailing Address 15342 W TURNEY AVE
City GOODYEAR
State AZ
ZIP 85395
Accounting period End 12
Primary contact name CAROLE SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLE SMITH
DIRECTOR
15342 W TURNEY AVE
GOODYEAR AZ 85395

Officer/Director/Trustee Two

MARKETHA WASHINGTON
DIRECTOR
2400 JUPITER ROAD UNIT A5
PLANO TX 75074

Officer/Director/Trustee Three

JANIS MOORE
DIRECTOR
3748 CREEKPARK STREET
RIVERSIDE CA 92501

Officer/Director/Trustee Four

CARLA THOMPSON
DIRECTOR
1306 CONVAIR STREET
BENTONVILLE AR 72712

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F70 - Mental Health Disorders
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 CAROLE SMITH
Signature Title DIRECTOR
Signature Date 6/18/18

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