FORM 1023-EZ for STUDENT OCCUPATIONAL THERAPY ASSOCIATION NAU

Field Data
EIN 47-3035256
Case Number EO-2018128-000679
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STUDENT OCCUPATIONAL THERAPY ASSOCIATION NAU
Organization’s Mailing Address 435 N 5TH ST
City PHOENIX
State AZ
ZIP 85004-2157
Accounting period End 6
Primary contact name CAROLYN SECHLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLY KERSAVAGE
PRESIDENT
4225 E MCDOWELL ROAD 2093
PHOENIX AZ 85008

Officer/Director/Trustee Two

ANDREW BENFORD
VICE PRESIDENT
532 E WILLETTA ST
PHOENIX AZ 85004

Officer/Director/Trustee Three

SAM KOGLER
SECRETARY
41424 N WHISTLING STRAIT DR
ANTHEM AZ 85086

Officer/Director/Trustee Four

ELIZABETH FROETSCHER
TREASURER
26708 N 90TH DR
PEORIA AZ 85383

Organization’s website HTTPS://NAU.CAMPUSLABS.COM/ENGAGE/ORGANIZATION/SOTA
Organization’s email EAF84@NAU.EDU
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: Yes
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 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 ELIZABETH FROETSCHER
Signature Title TREASURER
Signature Date 5/2/18
EIN 47-3035256
Case Number EO-2017114-000266
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STUDENT OCCUPATIONAL THERAPY ASSOCIATION NAU
Organization’s Mailing Address 435 N 5TH ST
City PHOENIX
State AZ
ZIP 85004-2157
Accounting period End 4
Primary contact name AMY ARMSTRONG-HEIMSOTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY ARMSTRONG-HEIMSOTH
FACULTY ADVISOR
435 N 5TH ST
PHOENIX AZ 85004-2157

Officer/Director/Trustee Two

CHRIS TRUJILLO
FACULTY ADVISOR
435 N 5TH ST
PHOENIX AZ 85004-2157

Officer/Director/Trustee Three

MOLLY HAHN-FLOYD
TREASURER
435 N 5TH ST
PHOENIX AZ 85004-2157

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2015
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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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