FORM 1023-EZ for AUDREY HARRIS VISION

Field Data
EIN 38-3953234
Case Number EO-2015043-000426
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AUDREY HARRIS VISION
Organization’s Mailing Address PO BOX 10333
City FAYETTEVILLE
State AR
ZIP 72703
Accounting period End 12
Primary contact name KRISTIN EVANS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KRISTIN EVANS
EXECUTIVE DIRECTOR
3787 BREAKSTONE DRIVE
FAYETTEVILLE AR 72764

Officer/Director/Trustee Two

MARCUS PINKNEY
DIRECTOR
6717 WORTH AVENUE EAST
BENTON AR 72019

Officer/Director/Trustee Three

CASEY HAMAKER
TREASURER
308 EAST SPRING STREET
FAYETTEVILLE AR 72701

Officer/Director/Trustee Four

SARAH PENNY
SECRETARY
2781 LEMONTREE
SPRINGDALE AR 72762

Organization’s website WWW.AUDREYHARRISVISION.ORG
Organization’s email KRISTINREVANS@HOTMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2014
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
Donation of funds Yes
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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