FORM 1023-EZ for ARIZONA CARE HOSPICE FOUNDATION

Field Data
EIN 81-2864518
Case Number EO-2017009-000256
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARIZONA CARE HOSPICE FOUNDATION
Organization’s Mailing Address 12035 N SAGUARO BLVD SUITE 101
City FOUNTAIN HILLS
State AZ
ZIP 85268-4623
Accounting period End 12
Primary contact name KELLI CASADY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUSTIN GARRETT
DIRECTOR
PO BOX 18093
FOUNTAIN HILLS AZ 85269-8093

Officer/Director/Trustee Two

STEPHEN WALL
DIRECTOR
10869 N SCOTTSDALE RD STE 103-205
SCOTTSDALE AZ 85254-5280

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P74 - Hospice
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 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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