FORM 1023-EZ for WILD HEARTS ANIMAL HAVEN

Field Data
EIN 47-3113363
Case Number EO-2015166-000395
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WILD HEARTS ANIMAL HAVEN
Organization’s Mailing Address PO BOX 678
City AUBREY
State TX
ZIP 76227-0678
Accounting period End 12
Primary contact name CAROL PLYBON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROL PLYBON
PRESIDENT/DIRECTOR
POBOX 668
AUBREY TX 76227-0668

Officer/Director/Trustee Two

TRAVIS PLYBON
DIRECTOR
PO BOX 668
AUBREY TX 76227-0668

Officer/Director/Trustee Three

MICHELLE KEHN
DIRECTOR
1000 WILLOWMIST
PROSPER TX 75078-8317

Officer/Director/Trustee Four

CASSIDY JAGGER
SECRETARY/DIRECTOR
4 FOX HOLLOW
SHADY SHORES TX 76208-5741

Officer/Director/Trustee Five

JORDAN LANCASTER
VICE PRESIDENT/DIRECTOR
605 OAKLAND STREET
DENTON TX 76201-3138

Organization’s website WILDHEARTSANIMALHAVEN.ORG
Organization’s email WILDHEARTS@WHAH.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
Organization’s purpose Charitable: Yes
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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