FORM 1023-EZ for PIECE OF HEAVEN ANIMAL RESCUE

Field Data
EIN 81-4378238
Case Number EO-2016319-000481
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PIECE OF HEAVEN ANIMAL RESCUE
Organization’s Mailing Address 3457 HWY 4 W
City SARAH
State MS
ZIP 38665
Accounting period End 11
Primary contact name STEPHANIE FLETCHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE PHILLIPS
CEO
3457 HWY 4 W
SARAH MS 38665

Officer/Director/Trustee Two

DESTINEY WHITE
CBO
2265 INDEPENDENCE
MILLINGTON TN 38053

Officer/Director/Trustee Three

SUSAN STEVENS
CIO
187 KAREN ST
MUNDFORD TN 38058

Officer/Director/Trustee Four

STEPHANIE FLETCHER
CFO
5420 HAYES ROAD
ARLINGTON TN 38002

Organization’s website
Organization’s email PIECEOFHEAVENANIMALRESCUE@HOTMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/2016
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
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 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 Yes
One Third Support Gifts No
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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