FORM 1023-EZ for KILLBUCK VALLEY VETERINARY MEDICALASSOCIATION

Field Data
EIN 47-5367678
Case Number EO-2015296-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KILLBUCK VALLEY VETERINARY MEDICALASSOCIATION
Organization’s Mailing Address C/O 140 WEST LIBERTY ST
City WOOSTER
State OH
ZIP 44691-4802
Accounting period End 12
Primary contact name WILLIAM YOST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM YOST
PRESIDENT
1665 NORTH MAIN ST
ORRVILLE OH 44667-9171

Officer/Director/Trustee Two

CARL SCHLATTER
SECRETARY - TREASURER
12366 GEARHART ROAD
BURBANK OH 44214-9724

Organization’s website
Organization’s email JDMUSSELMAN@TAGGARTLAWFIRM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D40 - Veterinary Services
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 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
Signature Title
Signature Date

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