FORM 1023-EZ for MERCY PHOENIX

Field Data
EIN 81-3873666
Case Number EO-2017006-000043
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MERCY PHOENIX
Organization’s Mailing Address 2421 WEST RUNNING DEER TRL
City PHOENIX
State AZ
ZIP 85085
Accounting period End 12
Primary contact name STEFFANY STANFIELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD HYATT
DIRECTOR
784 MCLENDON DRIVE
SCOTTSDALE GA 30079

Officer/Director/Trustee Two

CALEB NIEMIETZ
DIRECTOR
3334 WEST MELINDA LANE
PHOENIX AZ 85027

Officer/Director/Trustee Three

WESLEY STANFIELD
DIRECTOR
2421 WEST RUNNING DEER TRL
PHOENIX AZ 85085

Officer/Director/Trustee Four

STEFFANY STANFIELD
PRESIDENT SECRETARY
2421 WEST RUNNING DEER TRL
PHOENIX AZ 85085

Organization’s website WWW.MERCYPHX.COM
Organization’s email INFO@MERCYPHX.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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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