FORM 1023-EZ for ACADEMY OF DERMATOLOGY VETERINARY TECHNICIANS

Field Data
EIN 47-4431531
Case Number EO-2016221-000319
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACADEMY OF DERMATOLOGY VETERINARY TECHNICIANS
Organization’s Mailing Address 8813 JODY CIRCLE SOUTH
City COTTAGE GROVE
State MN
ZIP 55016
Accounting period End 6
Primary contact name CAROL GEORGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIM HORNE
PRESIDENT
13638 GOTHAM COURT
APPLE VALLEY MN 55124

Officer/Director/Trustee Two

SANDRA GRABLE
PRESIDENT-ELECT
2533 COUNTY ROAD 600 EAST
DEWEY IL 61840

Officer/Director/Trustee Three

CAROL GEORGE
TREASURER
8813 JODY CIRCLE SOUTH
COTTAGE GROVE MN 55016

Officer/Director/Trustee Four

JACQUELINE DAVIS
MEMBER AT LARGE
5010 ROWAN ROAD
KNOXVILLE TN 37912

Officer/Director/Trustee Five

JENNIE TAIT
SECRETARY
64 PINNACLE CRESCENT GUELPH
ONTARIO N1K 1P6

Organization’s website VETDERMTECH.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/2015
Organization Incorporation State MN
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: No
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 Yes
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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