FORM 1023-EZ for SOUTHERN ARIZONA AUTISM ASSOCIATION

Field Data
EIN 81-1203376
Case Number EO-2016074-000399
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTHERN ARIZONA AUTISM ASSOCIATION
Organization’s Mailing Address 67 E BAFFERT DRIVE
City NOGALES
State AZ
ZIP 85621
Accounting period End 12
Primary contact name RICHARD BRENNAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICHARD BRENNAN
TREASURER/DIRECTOR
563 AMARANTO CT
RIO RICO AZ 85648

Officer/Director/Trustee Two

FRANK BEJARANO
DIRECTOR
1116 VIA SAN FRANCISCO
RIO RICO AZ 85648

Officer/Director/Trustee Three

TANYA HENRY
DIRECTOR
108 MESA COURT
RIO RICO AZ 85648

Officer/Director/Trustee Four

MICHELLE JAQUEZ
BOARD CHAIRPERSON
2413 N AL HARRISON RD UNIT 2
NOGALES AZ 85621

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
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
Signature Title
Signature Date

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